Organization
SPROUTS PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAGE THIBDEAU PA-C (PSYCHIATRIC PA)
(720) 618-7098
Entity
Organization
Contact information
Practice address
561 W 173RD PL, BROOMFIELD, CO 80023-5202
(860) 961-8406
Mailing address
561 W 173RD PL, BROOMFIELD, CO 80023-5202
(860) 961-8406
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/17/2024
Last updated
09/29/2024
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