Provider Demographics
NPI:1306431077
Name:BERRY, SARAH BETH (ATC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:BERRY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 932
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30162-0932
Mailing Address - Country:US
Mailing Address - Phone:806-685-2783
Mailing Address - Fax:
Practice Address - Street 1:2277 MARTHA BERRY HWY NW
Practice Address - Street 2:
Practice Address - City:MOUNT BERRY
Practice Address - State:GA
Practice Address - Zip Code:30149-9707
Practice Address - Country:US
Practice Address - Phone:806-685-2783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program