Individual provider · NPI-1
Sarah Bethany Petrisin, MSEd, ATC, NCMT
Specialist/Technologist, Athletic Trainer · Ventura, CA
NPI number1124365028
StatusActive
Last updated in NPPESAug 30, 2016
Details
- NPI
- 1124365028
- Entity type
- Individual (NPI-1)
- Name
- Sarah Bethany Petrisin
- Credential
- MSEd, ATC, NCMT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 11, 2013
- Last updated
- Aug 30, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 0126000935 | VA | Yes |
| 225700000X | Massage Therapist | 0019007248 | VA | |
| 225700000X | Massage Therapist | 70569 | CA |
Practice location
7473 Eisenhower StVentura, CA 93003-2485
Phone 315-591-1166
Mailing address
7473 Eisenhower StVentura, CA 93003-2485
Phone 315-591-1166
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