Provider Demographics
NPI:1588122758
Name:REPP, SARAH ELLEN (DPT)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELLEN
Last Name:REPP
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELLEN
Other - Last Name:KISCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:1658 BOULDER CITY PKWY
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-1904
Mailing Address - Country:US
Mailing Address - Phone:702-530-6329
Mailing Address - Fax:702-952-5417
Practice Address - Street 1:1658 BOULDER CITY PKWY
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-1904
Practice Address - Country:US
Practice Address - Phone:702-530-6329
Practice Address - Fax:702-952-5417
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4001225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist