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General NPI Number Information
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NPI Number | 1588352595
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Entity Type | Organization
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Legal Business Name | SAGE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 1872 SOUTH PEARL STREET
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City | DENVER
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State | CO
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Zip | 80210-1512
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Country | US
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Telephone | 303-335-9661
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Fax |
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Provider Business Mailing Address
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Address Line | 1279 S SHERMAN ST
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City | DENVER
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State | CO
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Zip | 80210-1512
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Country | US
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Telephone | 440-823-9383
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE ELIZABETH KOCH
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Credential | DPT
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Telephone | 440-823-9383
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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 |
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License Number State |
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