Provider Demographics
NPI:1477230985
Name:POLTRACK, SARAH E (DPT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:POLTRACK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 HYDRAULIC RIDGE RD STE 4
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-8126
Mailing Address - Country:US
Mailing Address - Phone:348-170-9804
Mailing Address - Fax:434-817-0985
Practice Address - Street 1:285 HYDRAULIC RIDGE RD STE 4
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-8126
Practice Address - Country:US
Practice Address - Phone:434-817-0980
Practice Address - Fax:434-817-0985
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305215838225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist