Provider Demographics
NPI:1427682772
Name:SARA REARDON LLC
Entity type:Organization
Organization Name:SARA REARDON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:C
Authorized Official - Last Name:REARDON
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, WCS
Authorized Official - Phone:314-691-3878
Mailing Address - Street 1:6830 MEMPHIS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3342
Mailing Address - Country:US
Mailing Address - Phone:314-691-3878
Mailing Address - Fax:
Practice Address - Street 1:3915 BARONNE ST STE 3
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-5377
Practice Address - Country:US
Practice Address - Phone:504-814-3615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty