Individual
MR. SUDARSON GAUTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
446 OLD FARM RD APT 2, PALMYRA, PA 17078-8720
(717) 813-0115
Mailing address
446 OLD FARM RD, PALMYRA, PA 17078-8720
(717) 813-0115
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OC016192
PA
Other
Enumeration date
10/27/2014
Last updated
10/15/2025
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