Provider Demographics
NPI:1679792063
Name:FELVER, SARAH JANE (PTA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:FELVER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4209 E 300 N
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:IN
Mailing Address - Zip Code:47359-9717
Mailing Address - Country:US
Mailing Address - Phone:765-348-2466
Mailing Address - Fax:
Practice Address - Street 1:729 WEST 35TH ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953
Practice Address - Country:US
Practice Address - Phone:765-674-3371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06002456A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant