Provider Demographics
NPI:1629265962
Name:GREY, SARA ANN (PT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:GREY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 WATER ST
Mailing Address - Street 2:SUITE A-202
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4060
Mailing Address - Country:US
Mailing Address - Phone:508-830-0123
Mailing Address - Fax:508-830-0123
Practice Address - Street 1:225 WATER ST
Practice Address - Street 2:SUITE A-202
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4060
Practice Address - Country:US
Practice Address - Phone:508-830-0123
Practice Address - Fax:508-830-0234
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10487225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist