Healthcare Provider Details

I. General information

NPI: 1558191114
Provider Name (Legal Business Name): LINDSAY DAWN SACK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1093 E BRIDGE ST
BRIGHTON CO
80601-2252
US

IV. Provider business mailing address

7033 COUNTY ROAD 65
KEENESBURG CO
80643-9104
US

V. Phone/Fax

Practice location:
  • Phone: 303-655-9005
  • Fax:
Mailing address:
  • Phone: 303-709-1008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA0015554
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: