Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 05010006A | IN |
NPI | 1720454945 |
---|---|
Provider Name | Sara Bremer Sale |
First Address | Indianapolis, IN 46203-1151 |
Second Address | Indianapolis, IN 46203-1151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2015 |
Last Update Date | 12/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
46-1842276 | 46-1842276 (01) | IN |