Healthcare Provider Details

I. General information

NPI: 1497942288
Provider Name (Legal Business Name): SAHARAH, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 05/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 W US HIGHWAY 54 STE 103
CAMDENTON MO
65020-6942
US

IV. Provider business mailing address

396 W US HIGHWAY 54 STE 103
CAMDENTON MO
65020-6942
US

V. Phone/Fax

Practice location:
  • Phone: 573-317-0111
  • Fax: 573-317-1115
Mailing address:
  • Phone: 573-317-0111
  • Fax: 573-317-1115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RODNEY CREEDEN BROWNELL
Title or Position: OWNER/P.T.
Credential: P.T.
Phone: 573-317-0111