Provider Demographics
NPI:1699771899
Name:FORD, SARAH G (PT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:G
Last Name:FORD
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:5300 HICKORY PARK DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-2629
Mailing Address - Country:US
Mailing Address - Phone:804-756-8495
Mailing Address - Fax:804-270-7756
Practice Address - Street 1:13575 HEATHCOTE BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-6660
Practice Address - Country:US
Practice Address - Phone:571-261-9900
Practice Address - Fax:571-261-9908
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2015-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GAPT006269225100000X
GAATC0202022002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA65BBDHVMedicare PIN