Provider Demographics
NPI:1952955890
Name:WILLIAMS, SARAH PRESTON (MS, LAT-ATC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:PRESTON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, LAT-ATC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:PRESTON
Other - Last Name:GAYLORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ATC
Mailing Address - Street 1:710 BURNING TREE DR SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4722
Mailing Address - Country:US
Mailing Address - Phone:404-593-5028
Mailing Address - Fax:
Practice Address - Street 1:710 BURNING TREE DR SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-4722
Practice Address - Country:US
Practice Address - Phone:404-593-5028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-29
Last Update Date:2020-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0037702255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer