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General NPI Number Information
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NPI Number | 1467525113
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Entity Type | Individual
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Provider Name | SARA R TREADWELL P.T.
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Gender | Female
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 53-59 PUBLIC SQUARE SUITE 101
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City | WATERTOWN
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State | NY
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Zip | 13601-2603
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Country | US
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Telephone | 315-782-7872
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Fax | 315-782-7871
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Provider Business Mailing Address
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Address Line | 53-59 PUBLIC SQUARE SUITE 101
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City | WATERTOWN
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State | NY
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Zip | 13601-2603
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Country | US
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Telephone | 315-782-7872
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Fax | 315-782-7871
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 0034971
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 003497-1
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License Number State | NY
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