Provider Demographics
NPI:1932862836
Name:GURRY, SARAH MCMAHON (ATC, EMT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MCMAHON
Last Name:GURRY
Suffix:
Gender:F
Credentials:ATC, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-1518
Mailing Address - Country:US
Mailing Address - Phone:508-517-1121
Mailing Address - Fax:
Practice Address - Street 1:66 SPRING ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1518
Practice Address - Country:US
Practice Address - Phone:508-517-1121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAE884195207PE0004X
MA22592255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2259OtherLICENSED ATHLETIC TRAINER
MAE884195OtherEMT-B