Provider Demographics
NPI:1801406475
Name:GREGONIS, SARAH CHRISTINE (CMT)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:CHRISTINE
Last Name:GREGONIS
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12478 W NEVADA PL APT 211
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-3253
Mailing Address - Country:US
Mailing Address - Phone:303-249-9486
Mailing Address - Fax:
Practice Address - Street 1:1901 KIPLING ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-2822
Practice Address - Country:US
Practice Address - Phone:720-999-8550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0010061225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist