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General NPI Number Information
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NPI Number | 1063791796
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Entity Type | Organization
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Legal Business Name | SAGEWOOD PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 08/11/2011
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 1711 S PEARL ST
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City | DENVER
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State | CO
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Zip | 80210-3134
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Country | US
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Telephone | 303-733-5255
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 S PEARL ST
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City | DENVER
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State | CO
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Zip | 80210-3134
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MATTHEW ZEMMELMAN
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Credential | PT, DPT
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Telephone | 303-733-5255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 10681
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License Number State | CO
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