Basic Information
| Provider Information | |||||||||
| NPI: | 1578285425 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SABOLIK | ||||||||
| FirstName: | KIERSTEN | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7120 COUNTY ROAD 15 SW | ||||||||
| Address2: | |||||||||
| City: | KENSINGTON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563438185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3207603326 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10550 N LA CANADA DR STE 160 | ||||||||
| Address2: | |||||||||
| City: | ORO VALLEY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857377047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5205472476 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2022 | ||||||||
| LastUpdateDate: | 09/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.