Provider Demographics
NPI:1659998508
Name:RIEBEL, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:RIEBEL
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 1304
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:MT
Mailing Address - Zip Code:59729-1304
Mailing Address - Country:US
Mailing Address - Phone:616-516-8077
Mailing Address - Fax:
Practice Address - Street 1:30 STATE HIGHWAY 91
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725
Practice Address - Country:US
Practice Address - Phone:406-683-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant