MEDICARE: BROOKE ELIZABETH SACHAU MA, LAT, ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	120988	IA

General Provider Information

NPI Number	:	1619566296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE ELIZABETH SACHAU MA, LAT, ATC

Provider Business Mailing Address
First Line	:	402 6TH ST APT B6
Second Line	:
City	:	CORALVILLE
State	:	IA
Zip	:	52241-2563
Country	:	US
Telephone Number	:	732-874-1723
Fax Number	:

Provider Business Practice Location Address
First Line	:	402 6TH ST APT B6
Second Line	:
City	:	CORALVILLE
State	:	IA
Zip	:	52241-2563
Country	:	US
Telephone Number	:	732-874-1723
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2021
Last Update Date	:	05/04/2026

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