Healthcare Provider Details

I. General information

NPI: 1891017679
Provider Name (Legal Business Name): JENNIFER LEE ZIEGLER LMT,PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 03/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3522 HARTSEL DR
COLORADO SPRINGS CO
80920-4165
US

IV. Provider business mailing address

5196 LONE STAR PLACE
COLORADO SPRINGS CO
80922
US

V. Phone/Fax

Practice location:
  • Phone: 719-535-2757
  • Fax:
Mailing address:
  • Phone: 719-233-6105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number11624
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number5043
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: