Provider Demographics
NPI:1215592035
Name:GOOS, SARINA ROSE (PT,DPT, ATC)
Entity Type:Individual
Prefix:
First Name:SARINA
Middle Name:ROSE
Last Name:GOOS
Suffix:
Gender:F
Credentials:PT,DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6725 YORK AVE S APT 341
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-3226
Mailing Address - Country:US
Mailing Address - Phone:218-242-4717
Mailing Address - Fax:
Practice Address - Street 1:14046 IODINE ST NW
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-4648
Practice Address - Country:US
Practice Address - Phone:218-242-4717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer