Provider Demographics
NPI:1003086034
Name:SORRELLS, KRISTEN MARIE (PT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MARIE
Last Name:SORRELLS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:MARIE
Other - Last Name:WIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2329 W MAIN STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-8200
Mailing Address - Country:US
Mailing Address - Phone:303-797-0988
Mailing Address - Fax:303-797-8011
Practice Address - Street 1:2329 W MAIN STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8200
Practice Address - Country:US
Practice Address - Phone:303-797-0988
Practice Address - Fax:303-797-8011
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA255042251X0800X
COPTL.0009996225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic