Healthcare Provider Details

I. General information

NPI: 1861740995
Provider Name (Legal Business Name): SARAH RAE OUREN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2012
Last Update Date: 03/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6011 E WOODMEN RD STE 100
COLORADO SPRINGS CO
80923-2605
US

IV. Provider business mailing address

2140 HOLLOWBROOK DRIVE, SUITE 200
COLORADO SPRINGS CO
80918-6940
US

V. Phone/Fax

Practice location:
  • Phone: 719-571-8888
  • Fax: 719-571-8889
Mailing address:
  • Phone: 620-480-9361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-04409
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL0011652
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: