Provider Demographics
NPI:1376102103
Name:WILKINSON, SARA SINCLAIR
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:SINCLAIR
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 W 103RD AVE APT 1224
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80260-6197
Mailing Address - Country:US
Mailing Address - Phone:901-428-3644
Mailing Address - Fax:
Practice Address - Street 1:500 E 84TH AVE STE B14
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-5311
Practice Address - Country:US
Practice Address - Phone:303-287-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTLP.0000153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist