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General NPI Number Information
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NPI Number | 1912676610
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Entity Type | Individual
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Provider Name | SARA MARIE LAUDERMILCH
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Gender | Female
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 110 PIPEMAKERS CIR STE 115
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City | POOLER
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State | GA
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Zip | 31322-4168
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Country | US
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Telephone | 912-988-1526
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Fax |
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Provider Business Mailing Address
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Address Line | 269 WATCH HILL RD
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City | EXTON
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State | PA
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Zip | 19341-2190
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Country | US
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Telephone | 484-947-3851
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 28657
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License Number State | MD
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