Provider Demographics
NPI:1639280043
Name:BRYANT, SARA L (DPT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:BRYANT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1939 MINNEHAHA AVE W STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-1033
Mailing Address - Country:US
Mailing Address - Phone:651-748-4338
Mailing Address - Fax:
Practice Address - Street 1:600 MARKET ST STE 150
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-4570
Practice Address - Country:US
Practice Address - Phone:952-491-4700
Practice Address - Fax:952-491-4701
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7310225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN394585500Medicaid
MN7310OtherPHYSICAL THERAPY LICENSE
MN394585500Medicaid