MEDICARE: SARAH INGRID STROMSDORFER OTR

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1184096000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH INGRID STROMSDORFER OTR

Provider Business Mailing Address
First Line	:	460 MEDLOCK RD
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-1508
Country	:	US
Telephone Number	:	404-370-0460
Fax Number	:

Provider Business Practice Location Address
First Line	:	460 MEDLOCK RD
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-1508
Country	:	US
Telephone Number	:	404-370-0460
Fax Number	:

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

Provider Enumeration Date	:	10/30/2015
Last Update Date	:	05/01/2016

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