Provider Demographics
NPI:1093040305
Name:BROWN, SARAH EILEEN (DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:EILEEN
Last Name:BROWN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:EILEEN
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2201 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-4126
Mailing Address - Country:US
Mailing Address - Phone:515-707-0466
Mailing Address - Fax:
Practice Address - Street 1:5921 SE 14TH ST
Practice Address - Street 2:STE 2000
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50320-1746
Practice Address - Country:US
Practice Address - Phone:515-953-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA5222225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11415OtherPT STATE LICENSE NUMBER
IA5222OtherPT LICENSE
IAI19172Medicare PIN
IAI19172066Medicare PIN