Healthcare Provider Details

I. General information

NPI: 1598153447
Provider Name (Legal Business Name): SARAH MARIE WOMACK LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2014
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W COLUMBIA ST
FARMINGTON MO
63640-1719
US

IV. Provider business mailing address

108 W COLUMBIA ST
FARMINGTON MO
63640-1719
US

V. Phone/Fax

Practice location:
  • Phone: 573-516-0911
  • Fax:
Mailing address:
  • Phone: 573-516-0911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2025043113
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: