Healthcare Provider Details

I. General information

NPI: 1114299088
Provider Name (Legal Business Name): SARA STRICKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2012
Last Update Date: 02/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 E 23RD ST
FREMONT NE
68025-0800
US

IV. Provider business mailing address

1005 E 23RD ST
FREMONT NE
68025-0800
US

V. Phone/Fax

Practice location:
  • Phone: 866-784-2329
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2074588
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number01055
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA1423
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: