Provider Demographics
NPI:1245422039
Name:SACHTJEN, MICHELLE DAWN (PTA)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:DAWN
Last Name:SACHTJEN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 378TH
Mailing Address - Street 2:
Mailing Address - City:BEAVER CROSSING
Mailing Address - State:NE
Mailing Address - Zip Code:68313-9499
Mailing Address - Country:US
Mailing Address - Phone:402-532-7008
Mailing Address - Fax:
Practice Address - Street 1:578 378TH
Practice Address - Street 2:
Practice Address - City:BEAVER CROSSING
Practice Address - State:NE
Practice Address - Zip Code:68313-9499
Practice Address - Country:US
Practice Address - Phone:402-532-7008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE434225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant