Provider Demographics
NPI:1194542530
Name:WILKERSON, SARAH RENEE (PT, DPT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:RENEE
Last Name:WILKERSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21605 HIGHWAY 31 N
Mailing Address - Street 2:
Mailing Address - City:HENRYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47126-9128
Mailing Address - Country:US
Mailing Address - Phone:812-595-5006
Mailing Address - Fax:
Practice Address - Street 1:21605 HIGHWAY 31 N
Practice Address - Street 2:
Practice Address - City:HENRYVILLE
Practice Address - State:IN
Practice Address - Zip Code:47126-9128
Practice Address - Country:US
Practice Address - Phone:812-595-5006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05014678A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist