Provider Demographics
NPI:1548707474
Name:SMITH PANDL, SARAH KATHERINE (DPT)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:KATHERINE
Last Name:SMITH PANDL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:258 S MAIN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-5768
Mailing Address - Country:US
Mailing Address - Phone:435-514-5646
Mailing Address - Fax:435-774-1919
Practice Address - Street 1:8214 F ST STE C
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1740
Practice Address - Country:US
Practice Address - Phone:402-331-2273
Practice Address - Fax:402-933-4255
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007008756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist