Provider Demographics
NPI:1093914467
Name:SAUDER, JO ANN (PTA)
Entity Type:Individual
Prefix:MS
First Name:JO
Middle Name:ANN
Last Name:SAUDER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 VAN GUARD CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-8291
Mailing Address - Country:US
Mailing Address - Phone:717-314-8284
Mailing Address - Fax:
Practice Address - Street 1:9300 VAN GUARD CT
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-8291
Practice Address - Country:US
Practice Address - Phone:717-314-8284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA3136225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant