Most Relevant Information
Provider Data
| NPI Number: | 1003485566 |
| Provider Name: | SARAH SAMPLE ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/21/2021 |
| Last Updated: | 06/23/2021 |
Provider Practice Location
17 MAIN ST STE 403
ROBBINSVILLE
NJ
086911436
Practice Location Phone/Fax
| Phone: | 6096862050 |
| Fax: |
Provider Mailing Location
5802 FOREST XING
ERIE
PA
165067004
Provider Mailing Phone/Fax
| Phone: | 8147902902 |
| Fax: |