Provider Demographics
NPI:1295525350
Name:BRANSON, SARA ALICEAMAE (ATC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ALICEAMAE
Last Name:BRANSON
Suffix:
Gender:
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-2715
Mailing Address - Country:US
Mailing Address - Phone:417-255-7255
Mailing Address - Fax:
Practice Address - Street 1:128 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-2715
Practice Address - Country:US
Practice Address - Phone:417-255-7255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-10
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer