Provider Demographics
NPI:1477899755
Name:MARK, SARAH LORENE (ABMP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LORENE
Last Name:MARK
Suffix:
Gender:F
Credentials:ABMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 WASHTENAW AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4532
Mailing Address - Country:US
Mailing Address - Phone:734-332-3800
Mailing Address - Fax:
Practice Address - Street 1:2350 WASHTENAW AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4532
Practice Address - Country:US
Practice Address - Phone:734-332-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist