Provider Demographics
NPI:1992253876
Name:MERCHANT, SARA (PT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 24TH AVE NW
Mailing Address - Street 2:100
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6218
Mailing Address - Country:US
Mailing Address - Phone:405-447-1571
Mailing Address - Fax:
Practice Address - Street 1:724 24TH AVE NW
Practice Address - Street 2:100
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6218
Practice Address - Country:US
Practice Address - Phone:405-447-1571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4026225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist