Provider Demographics
NPI:1932729209
Name:HADDOX, SARAH (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HADDOX
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 1:371 NAVAJO TRL
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-4113
Mailing Address - Country:US
Mailing Address - Phone:304-617-9344
Mailing Address - Fax:
Practice Address - Street 1:371 NAVAJO TRL
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-4113
Practice Address - Country:US
Practice Address - Phone:304-617-9344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X, 175M00000X
WV2500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175M00000XOther Service ProvidersMidwife, LayGroup - Single Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty