Healthcare Provider Details

I. General information

NPI: 1194227835
Provider Name (Legal Business Name): SARAH KATHLEEN DAVIS PT, DPT, MS, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2018
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 VALMOORE DR
POQUOSON VA
23662-1244
US

IV. Provider business mailing address

30 VALMOORE DR
POQUOSON VA
23662-1244
US

V. Phone/Fax

Practice location:
  • Phone: 757-504-8181
  • Fax:
Mailing address:
  • Phone: 757-504-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0014481
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberJ3-0000783
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: