Provider Demographics
NPI:1861724155
Name:BURKS, SARAH S (PT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:S
Last Name:BURKS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:F
Other - Last Name:STROUDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 358
Mailing Address - Street 2:
Mailing Address - City:TIPTON
Mailing Address - State:IN
Mailing Address - Zip Code:46072-0358
Mailing Address - Country:US
Mailing Address - Phone:765-675-1745
Mailing Address - Fax:765-675-8257
Practice Address - Street 1:514 STATE ROAD 32 E
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-8767
Practice Address - Country:US
Practice Address - Phone:877-366-2663
Practice Address - Fax:317-867-3798
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009206A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist