Provider Demographics
NPI:1629444344
Name:SAVAGE, COLEIGH BROCK (DPT)
Entity Type:Individual
Prefix:
First Name:COLEIGH
Middle Name:BROCK
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:COLEIGH
Other - Middle Name:DANIELLE
Other - Last Name:BROCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1710 W 1ST ST STE D
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-1840
Practice Address - Country:US
Practice Address - Phone:319-273-8988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4035225100000X
IA091248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR4035OtherPHYSICAL THERAPY LICENSE NUMBER