Basic Information
| Provider Information | |||||||||
| NPI: | 1205105509 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CALVERT | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7517 W COLDSPRING RD | ||||||||
| Address2: | |||||||||
| City: | GREENFIELD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532202814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4143276603 | ||||||||
| FaxNumber: | 4143275411 | ||||||||
| Practice Location | |||||||||
| Address1: | 7517 W COLDSPRING RD | ||||||||
| Address2: | |||||||||
| City: | GREENFIELD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532202814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4143276603 | ||||||||
| FaxNumber: | 4143275411 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2011 | ||||||||
| LastUpdateDate: | 04/04/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0019X | 1764-26 | WI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation |
No ID Information.