Healthcare Provider Details

I. General information

NPI: 1528455334
Provider Name (Legal Business Name): SARA GEARY LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2015
Last Update Date: 04/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 STONECREEK DR S SUITE 101
PICKERINGTON OH
43147-9838
US

IV. Provider business mailing address

1501 STONECREEK DR S SUITE 101
PICKERINGTON OH
43147-9838
US

V. Phone/Fax

Practice location:
  • Phone: 614-604-6358
  • Fax:
Mailing address:
  • Phone: 614-604-6358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.020893
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: