Provider Demographics
NPI:1598153447
Name:WOMACK, SARAH MARIE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MARIE
Last Name:WOMACK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15672 490TH ST
Mailing Address - Street 2:
Mailing Address - City:SCARVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50473-7526
Mailing Address - Country:US
Mailing Address - Phone:640-591-5724
Mailing Address - Fax:
Practice Address - Street 1:115 N MILL ST
Practice Address - Street 2:
Practice Address - City:LAKE MILLS
Practice Address - State:IA
Practice Address - Zip Code:50450-1303
Practice Address - Country:US
Practice Address - Phone:641-592-2888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00622225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist