Provider Demographics
NPI:1326591843
Name:MCBRIEN, SARAH JOANN (MK, ATC, LAT)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:JOANN
Last Name:MCBRIEN
Suffix:
Gender:F
Credentials:MK, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 W. MICHIGAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-5406
Mailing Address - Country:US
Mailing Address - Phone:269-387-3099
Mailing Address - Fax:269-387-0677
Practice Address - Street 1:1903 W. MICHIGAN AVENUE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-5406
Practice Address - Country:US
Practice Address - Phone:269-387-3099
Practice Address - Fax:269-387-0677
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI26010010602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer