Healthcare Provider Details

I. General information

NPI: 1891613576
Provider Name (Legal Business Name): SARAH BENTLAGE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3244 51ST ST S
FARGO ND
58104-7179
US

IV. Provider business mailing address

4190 26TH AVE S
FARGO ND
58104-8567
US

V. Phone/Fax

Practice location:
  • Phone: 701-356-0062
  • Fax:
Mailing address:
  • Phone: 701-557-8071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2923
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: