Provider Demographics
NPI:1205237427
Name:BORTSCHELLER, SARA (ATC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BORTSCHELLER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 S JAYME CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-5702
Mailing Address - Country:US
Mailing Address - Phone:712-541-1472
Mailing Address - Fax:
Practice Address - Street 1:2215 W PENTAGON PL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57107-1104
Practice Address - Country:US
Practice Address - Phone:605-312-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-07
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD05102255A2300X
IA000893207PS0010X
NC2321207PS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine