MEDICARE: DR. SARAH LORRAINE FYOCK PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	070023763	IL
2	225100000X	Physical Therapist	J1-0004229	DE

General Provider Information

NPI Number	:	1114408473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH LORRAINE FYOCK PT, DPT

Provider Business Mailing Address
First Line	:	704 FALLON AVE
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19804-2114
Country	:	US
Telephone Number	:	856-514-1794
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 FALLON AVE
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19804-2114
Country	:	US
Telephone Number	:	856-514-1794
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2018
Last Update Date	:	01/21/2026

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Directions to “ DR. SARAH LORRAINE FYOCK PT, DPT” Practice Location

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