Provider Demographics
NPI:1659484749
Name:BACH, SARA CAROLINE (ATC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:CAROLINE
Last Name:BACH
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 NATIONAL CHAMPIONSHIP DR
Mailing Address - Street 2:MCKALE MEMORIAL CENTER #N108
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-0001
Mailing Address - Country:US
Mailing Address - Phone:520-621-3040
Mailing Address - Fax:520-621-8771
Practice Address - Street 1:1 NATIONAL CHAMPIONSHIP DR
Practice Address - Street 2:MCKALE MEMORIAL CENTER #N108
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0001
Practice Address - Country:US
Practice Address - Phone:520-621-3040
Practice Address - Fax:520-621-8771
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ04502255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer