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NPI Code Detail

MEDICARE: KATIE VONDERSAAR OTR

MEDICARE: KATIE VONDERSAAR 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
1225X00000XOccupational Therapist17180NC

General Provider Information

NPI Number : 1962919167
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE VONDERSAAR OTR
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 855-324-0885
Fax Number : 317-520-8200
Provider Business Practice Location Address
First Line : 701 FOREST POINT CIR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28273-6629
Country : US
Telephone Number : 980-375-6801
Fax Number : 317-520-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2018
Last Update Date : 04/02/2025

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Directions to “ KATIE VONDERSAAR OTR” Practice Location

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