Basic Information
| Provider Information | |||||||||
| NPI: | 1366033367 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TUTTLE | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | KIM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6828 SUGARLOAF KEY ST | ||||||||
| Address2: | |||||||||
| City: | LAKE WORTH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334677649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616853749 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2501 N A ST | ||||||||
| Address2: | |||||||||
| City: | LAKE WORTH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334606013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615859301 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2021 | ||||||||
| LastUpdateDate: | 02/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251G0304X | 36150 | FL | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics | 2251N0400X | 36150 | FL | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology | 225100000X | 36150 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.