Provider Demographics
NPI:1831846724
Name:JOHNSON, SARAH JANE (DPT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JANE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:JANE
Other - Last Name:CADWALLADER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2414 WELBECK DR
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3968
Mailing Address - Country:US
Mailing Address - Phone:319-558-7308
Mailing Address - Fax:
Practice Address - Street 1:1900 STONEY POINT RD SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-4961
Practice Address - Country:US
Practice Address - Phone:612-398-8149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA074023225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA074023OtherIOWA DEPARTMENT OF PUBLIC HEALTH