Provider Demographics
NPI:1558165126
Name:TEDFORD, SARA (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:TEDFORD
Suffix:
Gender:
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 1:404 SW CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LEON
Mailing Address - State:IA
Mailing Address - Zip Code:50144-1353
Mailing Address - Country:US
Mailing Address - Phone:417-298-3056
Mailing Address - Fax:
Practice Address - Street 1:302 NW 10TH ST
Practice Address - Street 2:
Practice Address - City:LEON
Practice Address - State:IA
Practice Address - Zip Code:50144-1220
Practice Address - Country:US
Practice Address - Phone:417-298-3056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00457-0225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist