Provider Demographics
NPI:1427610930
Name:STERRETT, CAROLYN DIANNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:DIANNE
Last Name:STERRETT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4284 TRAIL BOSS DR STE 130
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-7521
Mailing Address - Country:US
Mailing Address - Phone:303-663-8086
Mailing Address - Fax:303-663-8289
Practice Address - Street 1:4284 TRAIL BOSS DR STE 130
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-7521
Practice Address - Country:US
Practice Address - Phone:303-663-8086
Practice Address - Fax:303-663-8289
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
OR64786225100000X
COCP044323T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician