Provider Demographics
NPI:1578686309
Name:EVERT, SARA C (MOTR)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:C
Last Name:EVERT
Suffix:
Gender:F
Credentials:MOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4702 E ARKANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3412
Mailing Address - Country:US
Mailing Address - Phone:303-345-3753
Mailing Address - Fax:
Practice Address - Street 1:4702 E ARKANSAS AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3412
Practice Address - Country:US
Practice Address - Phone:303-345-3753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82209308Medicaid