Individual
SARA RENEA HUIZENGA
Active
Individual
SARA RENEA HUIZENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2812
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55422373
—
NM
01
—
NM00Q286
BLUE CROSS BLUE SHIELD NM
NM
Enumeration date
07/25/2006
Last updated
10/29/2009
Update your record
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