MEDICARE: JAMIE L O'MEARA PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5997	CO

General Provider Information

NPI Number	:	1215255211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE L O'MEARA PT

Provider Business Mailing Address
First Line	:	2821 S. PARKER RD
Second Line	:	SUITE 615
City	:	AURORA
State	:	CO
Zip	:	80014-0000
Country	:	US
Telephone Number	:	303-755-3170
Fax Number	:	303-755-3217

Provider Business Practice Location Address
First Line	:	2821 S. PARKER RD
Second Line	:	SUITE 615
City	:	AURORA
State	:	CO
Zip	:	80014-0000
Country	:	US
Telephone Number	:	303-755-3170
Fax Number	:	303-755-3217

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2010
Last Update Date	:	05/14/2010

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