Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 3001 | SC |
NPI | 1063665925 |
---|---|
Provider Name | Dr. Sara Virella Kraft |
First Address | Charleston, SC 29403-5836 |
Second Address | Charleston, SC 29403-5836 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2008 |
Last Update Date | 23/10/2008 |