Basic Information
Provider Information
NPI: 1417676180
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SARVER
FirstName: TIMOTHY
MiddleName: MICHAEL
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10268 W CENTENNIAL RD STE 101
Address2:  
City: LITTLETON
State: CO
PostalCode: 801276423
CountryCode: US
TelephoneNumber: 3039482999
FaxNumber: 3039488667
Practice Location
Address1: 10268 W CENTENNIAL RD STE 101
Address2:  
City: LITTLETON
State: CO
PostalCode: 801276423
CountryCode: US
TelephoneNumber: 3039482999
FaxNumber: 3039488667
Other Information
ProviderEnumerationDate: 08/25/2022
LastUpdateDate: 08/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X18645COY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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