Provider Demographics
NPI:1750266102
Name:PITTMAN, SARA ANN (LMT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ANN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:266 W 100 N STE 1
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2026
Mailing Address - Country:US
Mailing Address - Phone:435-828-3033
Mailing Address - Fax:
Practice Address - Street 1:266 W 100 N STE 1
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2026
Practice Address - Country:US
Practice Address - Phone:435-828-3033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3107047-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist