Provider Demographics
NPI:1417622911
Name:STUBBS, SARAH RENEE (DPT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:RENEE
Last Name:STUBBS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GRAMPIAN
Mailing Address - State:PA
Mailing Address - Zip Code:16838-9337
Mailing Address - Country:US
Mailing Address - Phone:814-236-0700
Mailing Address - Fax:
Practice Address - Street 1:258 MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAMPIAN
Practice Address - State:PA
Practice Address - Zip Code:16838-9337
Practice Address - Country:US
Practice Address - Phone:814-236-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT029677225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist