MEDICARE: MS. SARAH ANN SALMON M.S. OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	31004254A	IN

General Provider Information

NPI Number	:	1750535605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARAH ANN SALMON M.S. OTR

Provider Business Mailing Address
First Line	:	2310 BRIGHTWELL PL
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-6609
Country	:	US
Telephone Number	:	317-777-8256
Fax Number	:

Provider Business Practice Location Address
First Line	:	7424 SHADELAND STATION WAY
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3925
Country	:	US
Telephone Number	:	317-288-7606
Fax Number	:	317-288-7607

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2008
Last Update Date	:	07/23/2014

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