Provider Demographics
NPI:1215511571
Name:TRIPLETT, SARAH REBECCA (LPTA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:REBECCA
Last Name:TRIPLETT
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:FRIES
Mailing Address - State:VA
Mailing Address - Zip Code:24330-4064
Mailing Address - Country:US
Mailing Address - Phone:276-238-7464
Mailing Address - Fax:
Practice Address - Street 1:400 S INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:VA
Practice Address - Zip Code:24348-3972
Practice Address - Country:US
Practice Address - Phone:276-773-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306001096225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant