Provider Demographics
NPI:1891784690
Name:POCKER, SARAH E (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:POCKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 WHITEFISH STAGE
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2753
Mailing Address - Country:US
Mailing Address - Phone:406-756-7878
Mailing Address - Fax:406-257-7811
Practice Address - Street 1:1234 WHITEFISH STAGE
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2753
Practice Address - Country:US
Practice Address - Phone:406-756-7878
Practice Address - Fax:406-257-7811
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT982PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0197813OtherWA STATE WORK COMP
MT61128OtherBCBS OF MT
MT0348670Medicaid
MTMSF1196190OtherMT STATE FUND COMP
MT0348670Medicaid