Provider Demographics
NPI:1144549874
Name:COURTWRIGHT EDMONDSON, SARAH S (LMT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:S
Last Name:COURTWRIGHT EDMONDSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:S
Other - Last Name:COURTWRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3366 E 55TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44127-1638
Mailing Address - Country:US
Mailing Address - Phone:216-271-1133
Mailing Address - Fax:
Practice Address - Street 1:3366 E 55TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44127-1638
Practice Address - Country:US
Practice Address - Phone:216-271-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.017904C-D225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist