Healthcare Provider Details

I. General information

NPI: 1033217989
Provider Name (Legal Business Name): SARAH E PETRICH PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 UTICA AVE S
ST LOUIS PARK MN
55416-5312
US

IV. Provider business mailing address

5424 FRANCE AVE S APT 210
EDINA MN
55410-2367
US

V. Phone/Fax

Practice location:
  • Phone: 952-797-3141
  • Fax:
Mailing address:
  • Phone: 952-797-3141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7725
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: