Provider Demographics
NPI:1134853211
Name:BAINS, SIERRA ELIZABETH (PT, DPT)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:ELIZABETH
Last Name:BAINS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5116 SOUTHWEST AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-3430
Mailing Address - Country:US
Mailing Address - Phone:206-802-5822
Mailing Address - Fax:
Practice Address - Street 1:5116 SOUTHWEST AVE UNIT A
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-3430
Practice Address - Country:US
Practice Address - Phone:206-802-5822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1361735225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist