Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 2305210764 | VA |
NPI | 1114479359 |
---|---|
Provider Name | Sarah Hanby |
First Address | Virginia Beach, VA 23464-8277 |
Second Address | Virginia Beach, VA 23464-5368 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2016 |
Last Update Date | 03/11/2016 |