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NPI Code Detail

MEDICARE: SARAH MAUS DPT

MEDICARE: SARAH MAUS DPT
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
1225100000XPhysical Therapist070.022696IL
2225100000XPhysical Therapist2016027696MO

General Provider Information

NPI Number : 1972046886
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH MAUS DPT
Provider Business Mailing Address
First Line : 1901 FRANK SCOTT PKWY E
Second Line :
City : SHILOH
State : IL
Zip : 62269-7342
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1901 FRANK SCOTT PKWY E
Second Line :
City : SHILOH
State : IL
Zip : 62269-7342
Country : US
Telephone Number : 618-624-7077
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2016
Last Update Date : 11/25/2016

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