Provider Demographics
NPI:1174174437
Name:MCGRAIL, SARA BERTHA-A
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:BERTHA-A
Last Name:MCGRAIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 CHARTER DR
Mailing Address - Street 2:
Mailing Address - City:LONGS
Mailing Address - State:SC
Mailing Address - Zip Code:29568-5843
Mailing Address - Country:US
Mailing Address - Phone:843-446-4169
Mailing Address - Fax:
Practice Address - Street 1:646 CHARTER DR
Practice Address - Street 2:
Practice Address - City:LONGS
Practice Address - State:SC
Practice Address - Zip Code:29568-5843
Practice Address - Country:US
Practice Address - Phone:843-446-4169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer