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NPI Code Detail

MEDICARE: SARAH B. EBENHOE P.T.

MEDICARE: SARAH B. EBENHOE P.T.
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
1225100000XPhysical Therapist5118-024WI

General Provider Information

NPI Number : 1679693238
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH B. EBENHOE P.T.
Provider Business Mailing Address
First Line : 2455 N 124TH ST
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-4630
Country : US
Telephone Number : 262-782-9326
Fax Number : 262-782-9353
Provider Business Practice Location Address
First Line : 2455 N 124TH ST
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-4630
Country : US
Telephone Number : 262-782-9326
Fax Number : 262-782-9353
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 07/08/2007

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Directions to “ SARAH B. EBENHOE P.T.” Practice Location

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