Provider Demographics
NPI:1891912184
Name:MCCOLLUM-KNIGHT, SARAH (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MCCOLLUM-KNIGHT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 N 400 E
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-9276
Mailing Address - Country:US
Mailing Address - Phone:317-442-8253
Mailing Address - Fax:317-375-1482
Practice Address - Street 1:3040 N 400 E
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-9276
Practice Address - Country:US
Practice Address - Phone:317-442-8253
Practice Address - Fax:317-375-1482
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05002340A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist