Healthcare Provider Details

I. General information

NPI: 1659811602
Provider Name (Legal Business Name): SARAH FIKE LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2017
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 BIERER LN UPPR
UNIONTOWN PA
15401-3117
US

IV. Provider business mailing address

400 SUNSHINE HOLLOW RD
UNIONTOWN PA
15401-6846
US

V. Phone/Fax

Practice location:
  • Phone: 724-439-1088
  • Fax:
Mailing address:
  • Phone: 724-880-8787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMSG011269
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: