Provider Demographics
NPI:1851644744
Name:KREUL, SARA R (PT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:R
Last Name:KREUL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:YOHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3852 CREAMERY RD
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-9210
Mailing Address - Country:US
Mailing Address - Phone:203-389-6709
Mailing Address - Fax:203-389-6809
Practice Address - Street 1:3852 CREAMERY RD
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-9210
Practice Address - Country:US
Practice Address - Phone:203-389-6709
Practice Address - Fax:203-389-6809
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070017956225100000X
WI12564-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL6697019OtherMEDICARE
ILIL6237021OtherMEDICARE
ILIL6238021OtherMEDICARE