Provider Demographics
NPI:1255042941
Name:KHANOLKAR, SARIKA M (MHS)
Entity type:Individual
Prefix:
First Name:SARIKA
Middle Name:M
Last Name:KHANOLKAR
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5445 DTC PKWY STE 1130
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3038
Mailing Address - Country:US
Mailing Address - Phone:720-749-5599
Mailing Address - Fax:406-309-2579
Practice Address - Street 1:520 ZANG ST STE 250
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-8347
Practice Address - Country:US
Practice Address - Phone:303-214-7907
Practice Address - Fax:720-925-5897
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0018364225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist