Provider Demographics
NPI:1376684225
Name:HALLETT, SARAH K (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:K
Last Name:HALLETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:K
Other - Last Name:HOUMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4064 STARFLOWER RD
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-8457
Mailing Address - Country:US
Mailing Address - Phone:720-237-8428
Mailing Address - Fax:
Practice Address - Street 1:4064 STARFLOWER RD
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-8457
Practice Address - Country:US
Practice Address - Phone:720-237-8428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008971225100000X
CO9970225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9970OtherCO PT LICENSE
GAPT008971OtherPT LICENSE
GA65BBDZSMedicare PIN