Provider Demographics
NPI:1891994182
Name:BRENNAN, SARAH (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:WETTSTAEDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5100 GAMBLE DRIVE,
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1521
Mailing Address - Country:US
Mailing Address - Phone:952-545-6403
Mailing Address - Fax:952-545-2431
Practice Address - Street 1:2000 PLYMOUTH ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305
Practice Address - Country:US
Practice Address - Phone:952-545-6403
Practice Address - Fax:952-545-2431
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7955225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist