Provider Demographics
NPI:1558663385
Name:REICHERT, SARAH (LMT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:REICHERT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 52 BOX 8647
Mailing Address - Street 2:
Mailing Address - City:INDIAN
Mailing Address - State:AK
Mailing Address - Zip Code:99540-9602
Mailing Address - Country:US
Mailing Address - Phone:907-242-1137
Mailing Address - Fax:
Practice Address - Street 1:610 W 2ND AVE STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-2151
Practice Address - Country:US
Practice Address - Phone:907-242-1137
Practice Address - Fax:866-747-3256
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK944465172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist