Healthcare Provider Details

I. General information

NPI: 1073724027
Provider Name (Legal Business Name): SARAH ORTLIEB PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 N BANK DR
COLUMBUS OH
43220-5423
US

IV. Provider business mailing address

40 GLENMONT AVE
COLUMBUS OH
43214-3204
US

V. Phone/Fax

Practice location:
  • Phone: 614-273-3527
  • Fax: 614-451-0351
Mailing address:
  • Phone: 614-519-5616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT8496
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: