Healthcare Provider Details
I. General information
NPI: 1023795697
Provider Name (Legal Business Name): SARAH WRIGHT GILLS AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/05/2023
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1001 E LEIGH ST
RICHMOND VA
23298-5004
US
IV. Provider business mailing address
PO BOX 780125
PHILADELPHIA PA
19178-0125
US
V. Phone/Fax
- Phone: 804-828-0431
- Fax: 804-807-7950
- Phone: 804-922-4844
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 2201001922 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: