Provider Demographics
NPI:1154726784
Name:NEEDLER, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:NEEDLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17565 BOBO RD
Mailing Address - Street 2:
Mailing Address - City:GUYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45735-9513
Mailing Address - Country:US
Mailing Address - Phone:740-645-8002
Mailing Address - Fax:
Practice Address - Street 1:17565 BOBO ROAD
Practice Address - Street 2:
Practice Address - City:GUYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45735
Practice Address - Country:US
Practice Address - Phone:740-645-8002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH014301225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist