Provider Demographics
NPI:1689980427
Name:BERGER, SARAH REBECCA (MPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:REBECCA
Last Name:BERGER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 KING ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2573
Mailing Address - Country:US
Mailing Address - Phone:603-491-9056
Mailing Address - Fax:
Practice Address - Street 1:12 KING ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2573
Practice Address - Country:US
Practice Address - Phone:603-491-9056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3476225100000X
MA243365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist