Healthcare Provider Details

I. General information

NPI: 1598304693
Provider Name (Legal Business Name): JENNA ELIZABETH BAKER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2020
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4495 HALE PKWY STE 305
DENVER CO
80220-6204
US

IV. Provider business mailing address

1950 TRENTON ST APT 337
DENVER CO
80220-6614
US

V. Phone/Fax

Practice location:
  • Phone: 844-757-7450
  • Fax:
Mailing address:
  • Phone: 847-513-1949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0016783
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: