Provider Demographics
NPI:1548417181
Name:STAHL, SARI
Entity Type:Individual
Prefix:
First Name:SARI
Middle Name:
Last Name:STAHL
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:PO BOX 711185
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84171-1185
Mailing Address - Country:US
Mailing Address - Phone:801-942-3311
Mailing Address - Fax:801-495-5303
Practice Address - Street 1:2045 BROADWATER AVE
Practice Address - Street 2:STE 3
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4810
Practice Address - Country:US
Practice Address - Phone:406-656-0950
Practice Address - Fax:406-656-0970
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2130225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist