Provider Demographics
NPI:1255571444
Name:BARDWELL, SARAH (LMT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BARDWELL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 LAUFFER RAVINES DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-1600
Mailing Address - Country:US
Mailing Address - Phone:614-806-1333
Mailing Address - Fax:
Practice Address - Street 1:3804 FISHINGER BLVD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9551
Practice Address - Country:US
Practice Address - Phone:614-777-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.016055172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist