Provider Demographics
NPI:1740619626
Name:MAXWELL, SARAH ADRIENNE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ADRIENNE
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ADRIENNE
Other - Last Name:MACINNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:999 LAKE HUNTER CIR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5427
Mailing Address - Country:US
Mailing Address - Phone:843-388-3120
Mailing Address - Fax:843-353-2475
Practice Address - Street 1:999 LAKE HUNTER CIR
Practice Address - Street 2:SUITE B
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5427
Practice Address - Country:US
Practice Address - Phone:843-388-3120
Practice Address - Fax:843-353-2475
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6190225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist