Provider Demographics
NPI:1871060319
Name:QUESENBERRY, SARAH ANN (DPT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:QUESENBERRY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:SHARP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:574 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:VA
Mailing Address - Zip Code:24348-3879
Mailing Address - Country:US
Mailing Address - Phone:276-773-8118
Mailing Address - Fax:276-773-2219
Practice Address - Street 1:6045 OLD JONESBORO RD STE 1
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-3017
Practice Address - Country:US
Practice Address - Phone:423-534-4344
Practice Address - Fax:423-752-9561
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305212229225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305212229OtherVIRGINIA DEPARTMENT OF HEALTH
TN15292OtherTENNESSEE DEPARTMENT OF HEALTH