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General NPI Number Information
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NPI Number | 1558588269
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Entity Type | Individual
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Provider Name | SARAH CHADWICK FISHBACK PT
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Gender | Female
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2644 RIVA RD SCHOOL PT
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7427
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Country | US
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Telephone | 410-222-0069
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Fax | 410-222-0073
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Provider Business Mailing Address
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Address Line | 103 MILBURN CIR
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City | PASADENA
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State | MD
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Zip | 21122-6103
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Country | US
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Telephone | 410-437-3214
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 14382
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License Number State | MD
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