Provider Demographics
NPI:1174585939
Name:BRUMLEY, SARAH MARIE (ATC/L, EMT-B)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MARIE
Last Name:BRUMLEY
Suffix:
Gender:F
Credentials:ATC/L, EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23740 S.W. FRONTAGE RD.
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410
Mailing Address - Country:US
Mailing Address - Phone:618-201-0577
Mailing Address - Fax:
Practice Address - Street 1:20535 S LAGRANGE RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1345
Practice Address - Country:US
Practice Address - Phone:815-469-6676
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer