Provider Demographics
NPI:1548663131
Name:LOHSE, SARAH
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:LOHSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 PIPER HILL DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1690
Mailing Address - Country:US
Mailing Address - Phone:636-229-4254
Mailing Address - Fax:636-229-4253
Practice Address - Street 1:112 PIPER HILL DR
Practice Address - Street 2:SUITE 2
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1690
Practice Address - Country:US
Practice Address - Phone:636-229-4254
Practice Address - Fax:636-229-4253
Is Sole Proprietor?:No
Enumeration Date:2014-09-27
Last Update Date:2014-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120257172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer