MEDICARE: MISS JESSICA JOAN FRANCO MOT, OTR/L

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	225X00000X	Occupational Therapist	OT.0005572	CO

General Provider Information

NPI Number	:	1457833022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JESSICA JOAN FRANCO MOT, OTR/L

Provider Business Mailing Address
First Line	:	520 ZANG ST STE 212
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80021-8224
Country	:	US
Telephone Number	:	346-291-5853
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 ZANG ST STE 212
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80021-8224
Country	:	US
Telephone Number	:	346-291-5853
Fax Number	:

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

Provider Enumeration Date	:	08/30/2018
Last Update Date	:	08/30/2018

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