Basic Information
| Provider Information | |||||||||
| NPI: | 1881189678 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURKETT | ||||||||
| FirstName: | SARAH | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22907 NORTHWESTERN PIKE | ||||||||
| Address2: | |||||||||
| City: | ROMNEY | ||||||||
| State: | WV | ||||||||
| PostalCode: | 267576244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3047030138 | ||||||||
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| Practice Location | |||||||||
| Address1: | 254 RED CEDAR ST | ||||||||
| Address2: | |||||||||
| City: | BLUFFTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 299108967 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8438156999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2018 | ||||||||
| LastUpdateDate: | 06/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 5278 | SC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.