Healthcare Provider Details

I. General information

NPI: 1811242894
Provider Name (Legal Business Name): SARA MARIE KOTSCHI D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W LOOMIS RD
FRANKLIN WI
53132-8887
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-5044
US

V. Phone/Fax

Practice location:
  • Phone: 414-529-9200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12027-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: