Provider Demographics
NPI:1912192196
Name:MICHAUD, SARA E (PT, DPT, CLT-LANA)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:E
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:PT, DPT, CLT-LANA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1091
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02813-1124
Mailing Address - Country:US
Mailing Address - Phone:401-364-2020
Mailing Address - Fax:401-364-2030
Practice Address - Street 1:3939 OLD POST RD
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:RI
Practice Address - Zip Code:02813
Practice Address - Country:US
Practice Address - Phone:401-364-2020
Practice Address - Fax:401-364-2030
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI01887225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist