Provider Demographics
NPI:1942755590
Name:PATTON, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PATTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 CALDWELL RD
Mailing Address - Street 2:
Mailing Address - City:BRADNER
Mailing Address - State:OH
Mailing Address - Zip Code:43406-9752
Mailing Address - Country:US
Mailing Address - Phone:419-306-6403
Mailing Address - Fax:
Practice Address - Street 1:716 W MARKET ST
Practice Address - Street 2:# A
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-2582
Practice Address - Country:US
Practice Address - Phone:419-306-6403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.021864225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist