Provider Demographics
NPI:1063665925
Name:KRAFT, SARA VIRELLA (DPT, MHS, NCS, ATP)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:VIRELLA
Last Name:KRAFT
Suffix:
Gender:F
Credentials:DPT, MHS, NCS, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 ASHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5836
Mailing Address - Country:US
Mailing Address - Phone:843-792-3481
Mailing Address - Fax:843-792-0724
Practice Address - Street 1:169 ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5836
Practice Address - Country:US
Practice Address - Phone:843-792-3481
Practice Address - Fax:843-792-0724
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30012251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology