Healthcare Provider Details

I. General information

NPI: 1124803267
Provider Name (Legal Business Name): SARAH FOWLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 QUEBEC ST STE 215
DENVER CO
80230-7144
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 303-341-0369
  • Fax: 303-341-0866
Mailing address:
  • Phone: 410-885-4668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number120381
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0021420
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: