Provider Demographics
NPI:1275126864
Name:BROWN, SARAH RENAE (PTA)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:RENAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 789
Mailing Address - Street 2:
Mailing Address - City:MC COOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-0789
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:302 CENTER AVE
Practice Address - Street 2:
Practice Address - City:CURTIS
Practice Address - State:NE
Practice Address - Zip Code:69025-3014
Practice Address - Country:US
Practice Address - Phone:308-367-4885
Practice Address - Fax:308-367-4885
Is Sole Proprietor?:No
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1755225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant