Healthcare Provider Details

I. General information

NPI: 1932729209
Provider Name (Legal Business Name): SARAH HADDOX PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 02/12/2023
Certification Date: 02/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

371 NAVAJO TRL
HUNTINGTON WV
25705-4113
US

IV. Provider business mailing address

371 NAVAJO TRL
HUNTINGTON WV
25705-4113
US

V. Phone/Fax

Practice location:
  • Phone: 304-617-9344
  • Fax:
Mailing address:
  • Phone: 304-617-9344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2500
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: