Healthcare Provider Details

I. General information

NPI: 1245643626
Provider Name (Legal Business Name): SARAH CASTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 06/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3036 CLAIRMONT RD NE APT D
ATLANTA GA
30329-1627
US

IV. Provider business mailing address

3036 CLAIRMONT RD NE APT D
ATLANTA GA
30329-1627
US

V. Phone/Fax

Practice location:
  • Phone: 412-601-2192
  • Fax:
Mailing address:
  • Phone: 412-601-2192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number010288
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: