Provider Demographics
NPI:1689271405
Name:TEMPLETON, SARAH B (LMBT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:B
Last Name:TEMPLETON
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 GIBSON AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2245
Mailing Address - Country:US
Mailing Address - Phone:910-262-6799
Mailing Address - Fax:
Practice Address - Street 1:7036 WRIGHTSVILLE AVE # 102
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-3656
Practice Address - Country:US
Practice Address - Phone:910-262-6799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18813225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist