Provider Demographics
NPI:1801807839
Name:HOULE, SARAH (PT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HOULE
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:PO BOX 394
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-0394
Mailing Address - Country:US
Mailing Address - Phone:508-250-1134
Mailing Address - Fax:
Practice Address - Street 1:600 CLARK RD
Practice Address - Street 2:AOST
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1699
Practice Address - Country:US
Practice Address - Phone:978-452-3453
Practice Address - Fax:978-452-2652
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA121732251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY68314OtherINDIVDUAL BCBSMA #
MAY68314OtherINDIVDUAL BCBSMA #