Provider Demographics
NPI:1346433083
Name:VONBANK, SARAH MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:VONBANK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 3RD ST NE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:MN
Mailing Address - Zip Code:56069-1408
Mailing Address - Country:US
Mailing Address - Phone:952-200-4103
Mailing Address - Fax:
Practice Address - Street 1:1515 SAINT FRANCIS AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-3387
Practice Address - Country:US
Practice Address - Phone:952-403-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8008225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist