Provider Demographics
NPI:1164725867
Name:LINDROTH, SARAH ANN (PTA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:LINDROTH
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 1:1611 CRESTVIEW ST
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-5868
Mailing Address - Country:US
Mailing Address - Phone:608-449-0010
Mailing Address - Fax:
Practice Address - Street 1:3418 COUNTY ROAD F
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-0737
Practice Address - Country:US
Practice Address - Phone:608-757-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-18
Last Update Date:2015-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160.005499225200000X
WI1699-09225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant