Provider Demographics
NPI:1023866670
Name:MINIARD, SARAH LEIGHANN (PTA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LEIGHANN
Last Name:MINIARD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 GALLERY AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-5632
Mailing Address - Country:US
Mailing Address - Phone:757-230-9942
Mailing Address - Fax:
Practice Address - Street 1:1016 FIRST COLONIAL RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3073
Practice Address - Country:US
Practice Address - Phone:757-481-4066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant