Healthcare Provider Details

I. General information

NPI: 1154232155
Provider Name (Legal Business Name): SOPHIE SAKURA OSADA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4214 N ROXBORO ST STE 100
DURHAM NC
27704-1888
US

IV. Provider business mailing address

4214 N ROXBORO ST STE 100
DURHAM NC
27704-1888
US

V. Phone/Fax

Practice location:
  • Phone: 919-479-9001
  • Fax: 919-479-9003
Mailing address:
  • Phone: 919-479-9001
  • Fax: 919-479-9003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP25204
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: