Provider Demographics
NPI:1184909715
Name:WEISSENBUEHLER, SARAH A (RPT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:WEISSENBUEHLER
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 IVYDALE AVE
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-2411
Mailing Address - Country:US
Mailing Address - Phone:410-517-1936
Mailing Address - Fax:
Practice Address - Street 1:806 IVYDALE AVE
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-2411
Practice Address - Country:US
Practice Address - Phone:410-517-1936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21037225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist