Provider Demographics
NPI:1932327590
Name:LETTELLEIR, SARA ANN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:ANN
Last Name:LETTELLEIR
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 HUDSON RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-3350
Mailing Address - Country:US
Mailing Address - Phone:410-330-9425
Mailing Address - Fax:
Practice Address - Street 1:1805 HUDSON RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-3350
Practice Address - Country:US
Practice Address - Phone:410-330-9425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2016-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist