Healthcare Provider Details

I. General information

NPI: 1831707397
Provider Name (Legal Business Name): SARAH GEORGIA COVERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2020
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3647 HIGHWAY 39
KLAMATH FALLS OR
97603-2612
US

IV. Provider business mailing address

3647 HIGHWAY 39
KLAMATH FALLS OR
97603-2612
US

V. Phone/Fax

Practice location:
  • Phone: 541-884-5244
  • Fax:
Mailing address:
  • Phone: 541-884-5244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: