Provider Demographics
NPI:1053831784
Name:SIEVERS, SARAH C (DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:SIEVERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:C
Other - Last Name:JOHANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1400 N 500 E
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-2455
Mailing Address - Country:US
Mailing Address - Phone:435-755-3360
Mailing Address - Fax:
Practice Address - Street 1:1400 N 500 E
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-2455
Practice Address - Country:US
Practice Address - Phone:435-755-3360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11115853-2401225100000X
NE3710225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist