Sara Clark, DPT
Individual provider Active NPI Physical Therapist · Powell, WY
NPI 1992218325 · NPPES record last updated Nov 7, 2017
Key facts
- NPI
- 1992218325
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 639 W Coulter Ave
Powell, WY 82435-2527 - Phone
- (757) 739-0286
- NPI assigned
- Nov 7, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holistic Pain Management of Wyoming, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
639 W Coulter Ave
Powell, WY 82435-2527
Mailing address
639 W Coulter Ave
Powell, WY 82435-2527
Other providers in Powell, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.