Provider Demographics
NPI:1194945659
Name:THORNE, SARA GATES (PT, DPT, OCS)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:GATES
Last Name:THORNE
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W KEECH AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-5532
Mailing Address - Country:US
Mailing Address - Phone:773-580-9716
Mailing Address - Fax:
Practice Address - Street 1:3780 JACKSON RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-1871
Practice Address - Country:US
Practice Address - Phone:734-604-3383
Practice Address - Fax:877-663-9299
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010200802251X0800X
NC13913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070011679OtherPHYSICAL THERAPY LICENSE
NC13913OtherNC PT LICENSE