Provider Demographics
NPI:1013591833
Name:STAFFORD, SARAH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:STAFFORD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 FRIENDSHIP LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-1810
Mailing Address - Country:US
Mailing Address - Phone:719-660-5554
Mailing Address - Fax:
Practice Address - Street 1:2700 NE 4TH ST STE 105
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-3628
Practice Address - Country:US
Practice Address - Phone:541-323-5864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic