Individual
SARA MARIE NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA 002602
Contact information
Practice address
1539 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
(304) 363-8479
Mailing address
605 RIDGE CROSSING DRIVE, WOODSTOCK, GA 30189
(706) 951-5103
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 001284
WV
225200000X
Physical Therapy Assistant
PTA002602
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972726065
—
GA
05
—
1972726065
—
WV
Enumeration date
04/10/2007
Last updated
12/02/2021
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