Provider Demographics
NPI:1952858565
Name:PATTERSON, SARAH E (DPT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:E
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3899 W FRONT ST
Mailing Address - Street 2:UNIT 3
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-8103
Mailing Address - Country:US
Mailing Address - Phone:231-944-6541
Mailing Address - Fax:231-421-8447
Practice Address - Street 1:3899 W FRONT ST
Practice Address - Street 2:UNIT 3
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684
Practice Address - Country:US
Practice Address - Phone:231-421-9277
Practice Address - Fax:231-421-8447
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501017851OtherMICHIGAN LICENSE NUMBER