Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 0014198 | CO |
NPI | 1669846895 |
---|---|
Provider Name | Sarah Lange |
First Address | Denver, CO 80206-2996 |
Second Address | Aurora, CO 80045-7211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2015 |
Last Update Date | 18/06/2021 |