Provider Demographics
NPI:1639296882
Name:BRAINARD, SARA L (PT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:BRAINARD
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 1:4913 GOLD CREST DR
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:27310-9849
Mailing Address - Country:US
Mailing Address - Phone:336-932-7544
Mailing Address - Fax:
Practice Address - Street 1:1030 MALL LOOP RD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7656
Practice Address - Country:US
Practice Address - Phone:336-781-4320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9525225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist