Provider Demographics
NPI:1205175379
Name:ST. GELAIS, SARA (DPT, ATC)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:ST. GELAIS
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 BLAIR PARK RD
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-8037
Mailing Address - Country:US
Mailing Address - Phone:802-876-6000
Mailing Address - Fax:803-876-6003
Practice Address - Street 1:30 HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-8212
Practice Address - Country:US
Practice Address - Phone:802-876-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-08
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT40.00915422251X0800X, 2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT040.0091542OtherVERMONT STATE LICENSE