Provider Demographics
NPI:1548273220
Name:ACCACIAN, SARAH ANN (ATC)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANN
Last Name:ACCACIAN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:FAHRENKRUG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, LAT
Mailing Address - Street 1:1537 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-5759
Mailing Address - Country:US
Mailing Address - Phone:563-503-0868
Mailing Address - Fax:
Practice Address - Street 1:1550 CLARKE DR
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-3117
Practice Address - Country:US
Practice Address - Phone:563-503-0868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL96.0022982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer