Provider Demographics
NPI:1346706835
Name:MENZUBER, SARAH (BS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MENZUBER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 LAKE SUSAN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-8503
Mailing Address - Country:US
Mailing Address - Phone:952-607-8219
Mailing Address - Fax:
Practice Address - Street 1:1310 LAKE SUSAN HILLS DR
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-8503
Practice Address - Country:US
Practice Address - Phone:952-607-8219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program