Provider Demographics
NPI:1215562723
Name:EISWERTH, SARAH E (PT, DPT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:EISWERTH
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 1:9473 WHALERS CV
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4580
Mailing Address - Country:US
Mailing Address - Phone:440-339-2320
Mailing Address - Fax:
Practice Address - Street 1:2323 CONCRETE RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:KY
Practice Address - Zip Code:40311-9721
Practice Address - Country:US
Practice Address - Phone:859-289-3492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT018482225100000X
KY007916225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist