Provider Demographics
NPI:1689159246
Name:DESAUTEL, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DESAUTEL
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 1:8525 KELZER POND DR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:MN
Mailing Address - Zip Code:55386-4507
Mailing Address - Country:US
Mailing Address - Phone:952-334-7380
Mailing Address - Fax:
Practice Address - Street 1:10653 WAYZATA BLVD
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1528
Practice Address - Country:US
Practice Address - Phone:952-224-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-30
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist