=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912709247
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH M DUMAN PT, MSPT, CERT. MDT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2025
-----------------------------------------------------
Last Update Date | 03/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1891 HWY 40 E STE 1104
-----------------------------------------------------
City | KINGSLAND
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31548-6573
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 912-217-3753
-----------------------------------------------------
Fax | 912-522-8406
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1891 HWY 40 STE 1104
-----------------------------------------------------
City | KINGSLAND
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31548-6573
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 912-217-3753
-----------------------------------------------------
Fax | 912-522-8406
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT016958
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------