Provider Demographics
NPI:1962870501
Name:HARRELL, SARAH ANN (DPT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:HARRELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:HEINIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 AUGUSTA RD
Mailing Address - Street 2:114
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32407-0228
Mailing Address - Country:US
Mailing Address - Phone:937-267-2010
Mailing Address - Fax:
Practice Address - Street 1:1937 JENKS AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4510
Practice Address - Country:US
Practice Address - Phone:850-769-7686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 30762225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist