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General NPI Number Information
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NPI Number | 1700522588
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Entity Type | Individual
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Provider Name | SARA HARTL PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/05/2022
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 230 N WALWORTH AVE UNIT 2
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City | WILLIAMS BAY
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State | WI
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Zip | 53191-9202
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Country | US
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Telephone | 262-607-6677
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Fax | 262-474-3719
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Provider Business Mailing Address
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Address Line | 7930 HARWOOD AVE APT 308
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City | WAUWATOSA
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State | WI
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Zip | 53213-2570
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Country | US
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Telephone | 262-902-3057
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 15642-24
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License Number State | WI
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