Provider Demographics
NPI:1366955098
Name:RYAN, SARA E
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:RYAN
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 1:100 WONSETTLER RD
Mailing Address - Street 2:
Mailing Address - City:SCENERY HILL
Mailing Address - State:PA
Mailing Address - Zip Code:15360-1863
Mailing Address - Country:US
Mailing Address - Phone:724-945-5161
Mailing Address - Fax:
Practice Address - Street 1:100 WONSETTLER RD
Practice Address - Street 2:
Practice Address - City:SCENERY HILL
Practice Address - State:PA
Practice Address - Zip Code:15360-1863
Practice Address - Country:US
Practice Address - Phone:724-945-5161
Practice Address - Fax:724-945-5164
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT003881225100000X
PAPT003881225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist