Provider Demographics
NPI:1184874992
Name:PFEIFER, SARA MICHELE
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MICHELE
Last Name:PFEIFER
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 1:8318 NASHUA DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2749
Mailing Address - Country:US
Mailing Address - Phone:317-870-5798
Mailing Address - Fax:
Practice Address - Street 1:1228 LORNEWOOD DR
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-7137
Practice Address - Country:US
Practice Address - Phone:317-679-8995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06002292A225200000X
FLPTA25478225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant