Provider Demographics
NPI:1306176474
Name:GAUTIER, SABRINA DENNIS (CMT)
Entity type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:DENNIS
Last Name:GAUTIER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 STOCKPEN MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NARROWS
Mailing Address - State:VA
Mailing Address - Zip Code:24124-2354
Mailing Address - Country:US
Mailing Address - Phone:540-599-3102
Mailing Address - Fax:
Practice Address - Street 1:1205 STAFFORD DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2465
Practice Address - Country:US
Practice Address - Phone:304-913-4934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2003-1279172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist