Provider Demographics
NPI:1699186098
Name:FARRELL, SARA (PT, DPT, CLT)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:FARRELL
Suffix:
Gender:F
Credentials:PT, DPT, CLT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:GERVING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:604 E ASH AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ULLIN
Mailing Address - State:ND
Mailing Address - Zip Code:58631-7138
Mailing Address - Country:US
Mailing Address - Phone:701-348-3107
Mailing Address - Fax:701-348-3080
Practice Address - Street 1:604 E ASH AVE
Practice Address - Street 2:
Practice Address - City:GLEN ULLIN
Practice Address - State:ND
Practice Address - Zip Code:58631-7138
Practice Address - Country:US
Practice Address - Phone:701-348-3107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1757225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist