Provider Demographics
NPI:1831209352
Name:BOMMARITO, SARAH PARTRIDGE (OTR/L)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:PARTRIDGE
Last Name:BOMMARITO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9447 21ST RD
Mailing Address - Street 2:
Mailing Address - City:UDALL
Mailing Address - State:KS
Mailing Address - Zip Code:67146-7525
Mailing Address - Country:US
Mailing Address - Phone:316-207-5877
Mailing Address - Fax:
Practice Address - Street 1:914 S HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-4001
Practice Address - Country:US
Practice Address - Phone:316-618-1252
Practice Address - Fax:316-682-2798
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01223225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics