MEDICARE: SARA MILLER KLYCE OTR/L

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	4903	AL

General Provider Information

NPI Number	:	1275091779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA MILLER KLYCE OTR/L

Provider Business Mailing Address
First Line	:	8450 BRITTANY CT
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36695-3620
Country	:	US
Telephone Number	:	251-517-0355
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 HILLCREST RD STE 210
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36695-3916
Country	:	US
Telephone Number	:	251-517-0355
Fax Number	:

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

Provider Enumeration Date	:	03/04/2019
Last Update Date	:	03/11/2026

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