Provider Demographics
NPI:1023459377
Name:GOUPIL, SARAH M (PT)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:M
Last Name:GOUPIL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1455 W FAIR AVE
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-2654
Mailing Address - Country:US
Mailing Address - Phone:906-226-0574
Mailing Address - Fax:888-347-1135
Practice Address - Street 1:820 CARP RIVER LN
Practice Address - Street 2:STE 2
Practice Address - City:ISHPEMING
Practice Address - State:MI
Practice Address - Zip Code:49849-3187
Practice Address - Country:US
Practice Address - Phone:906-226-0574
Practice Address - Fax:888-347-1135
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009086225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist