Sara Jayne Spencer

Individual provider Active NPI Physical Therapy Assistant · Wray, CO

NPI 1831433176 · NPPES record last updated Nov 26, 2012

Key facts

NPI
1831433176
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
0012894 (CO)
Practice address
360 Canyon Ridge Dr
Wray, CO 80758-8947
Phone
(970) 332-4856
NPI assigned
Nov 26, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0012894COMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0012894 CO Yes

Addresses

Primary practice location

360 Canyon Ridge Dr
Wray, CO 80758-8947

Mailing address

31114 County Road Z
Wray, CO 80758-9710

Other providers in Wray, CO

All providers in Wray, CO · Physical Therapy Assistant in Colorado

Sources for this page

Verify at the official NPI Registry.