Provider Demographics
NPI:1548483621
Name:SAGE, LINDA L (PT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:SAGE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 N MOSS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-0626
Mailing Address - Country:US
Mailing Address - Phone:432-264-2650
Mailing Address - Fax:432-268-9897
Practice Address - Street 1:309 N MOSS LAKE RD
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-0626
Practice Address - Country:US
Practice Address - Phone:432-264-2650
Practice Address - Fax:432-268-9897
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1026219225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist