Provider Demographics
NPI:1760867857
Name:MIKO, SARAH CAITLIN (ATC)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:CAITLIN
Last Name:MIKO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 RICHLAND AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-3277
Mailing Address - Country:US
Mailing Address - Phone:330-317-9215
Mailing Address - Fax:
Practice Address - Street 1:363 RICHLAND AVE APT 204
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-3277
Practice Address - Country:US
Practice Address - Phone:330-317-9215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0046522255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer