Healthcare Provider Details

I. General information

NPI: 1255657102
Provider Name (Legal Business Name): JUDITH LYNN FREEMAN OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2010
Last Update Date: 04/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5975 S QUEBEC ST SUITE 141
CENTENNIAL CO
80111-4564
US

IV. Provider business mailing address

3082 S WHEELING WAY #109
AURORA CO
80014-3655
US

V. Phone/Fax

Practice location:
  • Phone: 720-489-0343
  • Fax: 720-489-0385
Mailing address:
  • Phone: 303-923-3160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number2828
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: