Provider Demographics
NPI:1689322091
Name:GRACE, SARA J (DPT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:J
Last Name:GRACE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 DRUMLIN RD
Mailing Address - Street 2:
Mailing Address - City:PERKINSVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05151-9670
Mailing Address - Country:US
Mailing Address - Phone:802-738-6867
Mailing Address - Fax:
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-3572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist