Provider Demographics
NPI:1275395337
Name:SACO, SERGIO A (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:A
Last Name:SACO
Suffix:
Gender:M
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 1:881 WOODHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-5800
Mailing Address - Country:US
Mailing Address - Phone:949-872-9864
Mailing Address - Fax:
Practice Address - Street 1:881 WOODHAVEN DR
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-5800
Practice Address - Country:US
Practice Address - Phone:949-872-9864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501303095225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist