Healthcare Provider Details

I. General information

NPI: 1124145511
Provider Name (Legal Business Name): SARAH CURTIS MS, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 W AVON RD
AVON CT
06001-3680
US

IV. Provider business mailing address

11 DARLING ST APT H
SOUTHINGTON CT
06489-2610
US

V. Phone/Fax

Practice location:
  • Phone: 860-675-0357
  • Fax:
Mailing address:
  • Phone: 860-836-7784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number000026
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: