Provider Demographics
NPI:1134351174
Name:ENGA, SARAH ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:ENGA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:48 29TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4589
Mailing Address - Country:US
Mailing Address - Phone:320-240-0300
Mailing Address - Fax:320-240-0303
Practice Address - Street 1:48 29TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4589
Practice Address - Country:US
Practice Address - Phone:320-240-0300
Practice Address - Fax:320-240-0303
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8353225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN8353OtherLICENSE