Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3102 | WV |
NPI | 1003133703 |
---|---|
Provider Name | Sarah Sturm |
First Address | Vienna, WV 26105-1079 |
Second Address | Charleston, WV 25303-1207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2010 |
Last Update Date | 12/08/2020 |