Provider Demographics
NPI:1932436367
Name:THOMAS, SARAH E (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:STUPAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:415 BENEDUM DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1503
Mailing Address - Country:US
Mailing Address - Phone:877-842-9887
Mailing Address - Fax:304-842-9888
Practice Address - Street 1:2525 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-3634
Practice Address - Country:US
Practice Address - Phone:304-723-3160
Practice Address - Fax:304-723-3849
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT002720225100000X
OHPT012315225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist