Provider Demographics
NPI:1821679010
Name:WOLLAM, SARAH COX (MSAT, LAT, ATC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:COX
Last Name:WOLLAM
Suffix:
Gender:F
Credentials:MSAT, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 WEXFORD DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31721-2017
Mailing Address - Country:US
Mailing Address - Phone:229-395-5100
Mailing Address - Fax:
Practice Address - Street 1:3700 NW CARY PKWY STE 110
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8446
Practice Address - Country:US
Practice Address - Phone:919-238-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-55352255A2300X
GA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer