Individual
SARA ROARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9047 W GREENFILED AVE, WEST ALLIS, WI 53214-2808
(414) 453-9290
(414) 777-7356
Mailing address
9047 W GREENFIELD AVE, WEST ALLIS, WI 53214-2808
(414) 453-9290
(414) 777-7356
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2143-19
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598750671
—
WI
Enumeration date
12/05/2014
Last updated
12/05/2014
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