Provider Demographics
NPI:1790819118
Name:ADAMS, SARAH M (MS, PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7009 STONEY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3010
Mailing Address - Country:US
Mailing Address - Phone:618-977-9525
Mailing Address - Fax:618-692-4561
Practice Address - Street 1:7009 STONEY CREEK DR
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-3010
Practice Address - Country:US
Practice Address - Phone:618-977-9525
Practice Address - Fax:618-692-4561
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-12376225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist