Provider Demographics
NPI:1336278241
Name:CASTONGUAY, SARA SEMONES (PT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:SEMONES
Last Name:CASTONGUAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 CATHERINE CT.
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-6445
Mailing Address - Country:US
Mailing Address - Phone:717-277-0786
Mailing Address - Fax:
Practice Address - Street 1:318 CATHERINE CT.
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-6445
Practice Address - Country:US
Practice Address - Phone:717-277-0786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011045L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist