Provider Demographics
NPI:1073724027
Name:ORTLIEB, SARAH (PT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:ORTLIEB
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 GLENMONT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3204
Mailing Address - Country:US
Mailing Address - Phone:614-519-5616
Mailing Address - Fax:
Practice Address - Street 1:2335 N BANK DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-5423
Practice Address - Country:US
Practice Address - Phone:614-273-3527
Practice Address - Fax:614-451-0351
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT8496225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist