Healthcare Provider Details

I. General information

NPI: 1558435669
Provider Name (Legal Business Name): SARAH KNOWLAND ELDRED DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 ROUTE 137
EAST HARWICH MA
02645-1320
US

IV. Provider business mailing address

PO BOX 167
EAST DENNIS MA
02641-0167
US

V. Phone/Fax

Practice location:
  • Phone: 508-432-5760
  • Fax: 508-432-5829
Mailing address:
  • Phone: 508-221-3885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number16798
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: