Healthcare Provider Details

I. General information

NPI: 1578698304
Provider Name (Legal Business Name): SARAH W HAIGWOOD PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 W H SMITH BLVD
GREENVILLE NC
27834-5052
US

IV. Provider business mailing address

1872 QUAIL RIDGE RD APT H
GREENVILLE NC
27858-5509
US

V. Phone/Fax

Practice location:
  • Phone: 252-847-2000
  • Fax: 252-321-6004
Mailing address:
  • Phone: 252-916-3339
  • Fax: 252-321-6004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number338
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: