Basic Information
| Provider Information | |||||||||
| NPI: | 1548663131 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOHSE | ||||||||
| FirstName: | SARAH | ||||||||
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| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 112 PIPER HILL DR | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | SAINT PETERS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633761690 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6362294254 | ||||||||
| FaxNumber: | 6362294253 | ||||||||
| Practice Location | |||||||||
| Address1: | 112 PIPER HILL DR | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | SAINT PETERS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633761690 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6362294254 | ||||||||
| FaxNumber: | 6362294253 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2014 | ||||||||
| LastUpdateDate: | 09/27/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | 2012025717 | MO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.