Provider Demographics
NPI:1588114318
Name:MCGLOTHLIN, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MCGLOTHLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24201-3274
Mailing Address - Country:US
Mailing Address - Phone:276-669-4711
Mailing Address - Fax:
Practice Address - Street 1:8903 NEW GARDEN RD
Practice Address - Street 2:
Practice Address - City:HONAKER
Practice Address - State:VA
Practice Address - Zip Code:24260-6196
Practice Address - Country:US
Practice Address - Phone:276-202-0083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131000393224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant