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Individual

SAGE STOUT JOHANNESSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
3040 BERKMAR DR STE A1, CHARLOTTESVILLE, VA 22901-1593
(434) 979-8628
Mailing address
1618 CAMBRIDGE CIR, CHARLOTTESVILLE, VA 22903-1316
(802) 922-0753

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2305212499
VA

Other

Enumeration date
11/30/2022
Last updated
11/05/2025
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