Provider Demographics
NPI:1578285425
Name:SABOLIK, KIERSTEN (DPT)
Entity Type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:
Last Name:SABOLIK
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 1:7120 COUNTY ROAD 15 SW
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:56343-8185
Mailing Address - Country:US
Mailing Address - Phone:320-760-3326
Mailing Address - Fax:
Practice Address - Street 1:3060 FRONTIER WAY S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8909
Practice Address - Country:US
Practice Address - Phone:701-232-2340
Practice Address - Fax:701-232-2330
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-32661225100000X
MAPTL26721225100000X
MN12688225100000X
225100000X
ND2465225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist