Provider Demographics
NPI:1528041795
Name:BENDER, SARA L (DPT PT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:BENDER
Suffix:
Gender:F
Credentials:DPT PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 SHAWNEE RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3583
Mailing Address - Country:US
Mailing Address - Phone:419-999-2010
Mailing Address - Fax:419-999-6284
Practice Address - Street 1:1100 SHAWNEE RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-3529
Practice Address - Country:US
Practice Address - Phone:419-999-2010
Practice Address - Fax:419-999-6284
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT08635225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00344606OtherRAIL ROAD MEDICARE
OH11576173OtherCAQH UNIVERSAL CREDENTIAL
OH000000342249OtherANTHEM BLUE CROSS BLUE SH
OH2453438Medicaid
OHBE4122641Medicare ID - Type UnspecifiedMEDICARE
OHP00344606OtherRAIL ROAD MEDICARE