Healthcare Provider Details
I. General information
NPI: 1356269013
Provider Name (Legal Business Name): SARAH WILMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1573 S CATAWBA CIR
AURORA CO
80018-6012
US
IV. Provider business mailing address
510 BARRETT ST
SULPHUR LA
70663-2316
US
V. Phone/Fax
- Phone: 720-473-9791
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225200000X |
| Taxonomy | Physical Therapy Assistant |
| License Number | 0015541 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: