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NPI Code Detail

MEDICARE: MRS. SARA ELIZABETH REDWINE PTA

MEDICARE:  MRS. SARA ELIZABETH REDWINE  PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantA2835NC

General Provider Information

NPI Number : 1528302809
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SARA ELIZABETH REDWINE PTA
Provider Business Mailing Address
First Line : 24724 S BUSINESS 52
Second Line :
City : ALBEMARLE
State : NC
Zip : 28001-8179
Country : US
Telephone Number : 704-986-0862
Fax Number :
Provider Business Practice Location Address
First Line : 24724 S BUSINESS 52
Second Line :
City : ALBEMARLE
State : NC
Zip : 28001-8179
Country : US
Telephone Number : 704-986-0862
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2012
Last Update Date : 11/27/2012

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Directions to “ MRS. SARA ELIZABETH REDWINE PTA” Practice Location

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