Provider Demographics
NPI:1720042781
Name:WILLIAMS, SARAH JENNIFER (MS, ATC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JENNIFER
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 FAIRGROUNDS DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40516-9690
Mailing Address - Country:US
Mailing Address - Phone:859-323-5533
Mailing Address - Fax:
Practice Address - Street 1:740 S. LIMESTONE
Practice Address - Street 2:KENTCUKY CLINIC K401
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-5533
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT5262255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer