Provider Demographics
NPI:1427252162
Name:SAUER, JUDITH BUSH (OTR L)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:BUSH
Last Name:SAUER
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 1:1079 VICTOR LN
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1748
Mailing Address - Country:US
Mailing Address - Phone:610-527-7714
Mailing Address - Fax:610-527-7716
Practice Address - Street 1:1079 VICTOR LN
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1748
Practice Address - Country:US
Practice Address - Phone:610-527-7714
Practice Address - Fax:610-527-7716
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000555L171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor