Provider Demographics
NPI:1730431859
Name:SADAGURSKY, THOMAS (PTA)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:SADAGURSKY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28744-0655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:190 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HIGHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28741-7600
Practice Address - Country:US
Practice Address - Phone:828-526-1457
Practice Address - Fax:828-526-1340
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA4359225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant