Provider Demographics
NPI:1871099325
Name:CANTINE, SARA LYNNE
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:LYNNE
Last Name:CANTINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4013 W 84TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-6011
Mailing Address - Country:US
Mailing Address - Phone:701-412-7052
Mailing Address - Fax:
Practice Address - Street 1:4013 W 84TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-6011
Practice Address - Country:US
Practice Address - Phone:701-412-7052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment