MEDICARE: MS. SARA J HOMAN PT

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	225100000X	Physical Therapist	488	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831192905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARA J HOMAN PT

Provider Business Mailing Address
First Line	:	PO BOX 32490
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85064-2490
Country	:	US
Telephone Number	:	602-230-4478
Fax Number	:	602-230-9962

Provider Business Practice Location Address
First Line	:	8811 N 51ST AVE
Second Line	:	STE 102
City	:	GLENDALE
State	:	AZ
Zip	:	85302-4949
Country	:	US
Telephone Number	:	623-915-2726
Fax Number	:	623-915-2728

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/16/2007

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