Provider Demographics
NPI:1336680636
Name:POPE-EAGEN, CHERYL (PT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:POPE-EAGEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1262 BERGEN PKWY
Mailing Address - Street 2:SUITE E-10
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-9546
Mailing Address - Country:US
Mailing Address - Phone:303-674-7889
Mailing Address - Fax:303-674-8117
Practice Address - Street 1:1262 BERGEN PKWY
Practice Address - Street 2:SUITE E-10
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-9546
Practice Address - Country:US
Practice Address - Phone:303-674-7889
Practice Address - Fax:303-674-8117
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0002914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist