Provider Demographics
NPI:1134474885
Name:COLLINS, SARAH MELISSA (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:MELISSA
Last Name:COLLINS
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 1:711 N TEJON ST
Mailing Address - Street 2:# 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1011
Mailing Address - Country:US
Mailing Address - Phone:719-381-4357
Mailing Address - Fax:719-381-4359
Practice Address - Street 1:525 N CASCADE AVE
Practice Address - Street 2:SUITE 1 LL
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3308
Practice Address - Country:US
Practice Address - Phone:719-381-4357
Practice Address - Fax:719-381-4359
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011743225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist