Provider Demographics
NPI:1932564358
Name:SKIPPER, SARA ANN (PTA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:SKIPPER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ANN
Other - Last Name:WHITTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-362-8684
Practice Address - Street 1:400 TOWER RD NE STE 140
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-9412
Practice Address - Country:US
Practice Address - Phone:770-439-9437
Practice Address - Fax:770-419-9443
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA003233225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant