Provider Demographics
NPI:1811361017
Name:SELL, SADIE (LMT)
Entity Type:Individual
Prefix:
First Name:SADIE
Middle Name:
Last Name:SELL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 44TH ST
Mailing Address - Street 2:SUITE 10,000
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-3846
Mailing Address - Country:US
Mailing Address - Phone:319-373-7311
Mailing Address - Fax:319-373-7313
Practice Address - Street 1:999 44TH ST
Practice Address - Street 2:SUITE 10,000
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-3846
Practice Address - Country:US
Practice Address - Phone:319-373-7311
Practice Address - Fax:319-373-7313
Is Sole Proprietor?:No
Enumeration Date:2015-11-25
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007065225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist