Provider Demographics
NPI:1710187828
Name:JONES, SARA ANNE (MPT)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:ANNE
Last Name:JONES
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 1:833 N. 26TH STREET
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-1507
Mailing Address - Country:US
Mailing Address - Phone:414-344-7676
Mailing Address - Fax:414-344-7739
Practice Address - Street 1:833 N. 26TH STREET
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-1507
Practice Address - Country:US
Practice Address - Phone:414-344-7676
Practice Address - Fax:414-344-7739
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10166-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist