Provider Demographics
NPI:1194340844
Name:DESABATINE, SARAH NELL (PTA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NELL
Last Name:DESABATINE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12583 HURLOCK DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-1100
Mailing Address - Country:US
Mailing Address - Phone:317-366-4626
Mailing Address - Fax:
Practice Address - Street 1:7960 N SHADELAND AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2081
Practice Address - Country:US
Practice Address - Phone:317-376-4639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant