Provider Demographics
NPI:1548495930
Name:BEVILLE, SARAH (ATC, ROT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BEVILLE
Suffix:
Gender:F
Credentials:ATC, ROT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ELM ST
Mailing Address - Street 2:APARTMENT 305
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-1741
Mailing Address - Country:US
Mailing Address - Phone:913-481-7011
Mailing Address - Fax:
Practice Address - Street 1:11 ELM ST
Practice Address - Street 2:APARTMENT 305
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-1741
Practice Address - Country:US
Practice Address - Phone:913-481-7011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer