Provider Demographics
NPI:1295422426
Name:CROWE, SARAH J (PTA, CLT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:CROWE
Suffix:
Gender:F
Credentials:PTA, CLT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:J
Other - Last Name:LARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA, CLT
Mailing Address - Street 1:3026 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-1410
Mailing Address - Country:US
Mailing Address - Phone:612-386-3128
Mailing Address - Fax:
Practice Address - Street 1:3026 8TH AVE
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-1410
Practice Address - Country:US
Practice Address - Phone:612-386-3128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA1697225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant