Provider Demographics
NPI:1326678525
Name:MANZER, SARA ELIZABETH
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ELIZABETH
Last Name:MANZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:PAYETTE
Mailing Address - State:ID
Mailing Address - Zip Code:83661-2740
Mailing Address - Country:US
Mailing Address - Phone:208-800-1653
Mailing Address - Fax:
Practice Address - Street 1:2430 CENTER AVE
Practice Address - Street 2:
Practice Address - City:PAYETTE
Practice Address - State:ID
Practice Address - Zip Code:83661-2740
Practice Address - Country:US
Practice Address - Phone:208-800-1653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care