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General NPI Number Information
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NPI Number | 1235683434
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Entity Type | Individual
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Provider Name | SARAH MIDDLEBROOKS AT
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Gender | Female
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Dates
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Enumeration Date | 08/05/2016
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 1 CHILDRENS PLZ
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City | DAYTON
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State | OH
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Zip | 45404-1873
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Country | US
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Telephone | 937-641-3883
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Fax |
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Provider Business Mailing Address
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Address Line | 2108 SOUTHDOWN CT
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City | XENIA
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State | OH
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Zip | 45385-7083
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 005000
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License Number State | OH
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