Healthcare Provider Details

I. General information

NPI: 1962056796
Provider Name (Legal Business Name): JASMINE REYNOLDS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 12/01/2022
Certification Date: 12/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 PECOS ST STE 140
DENVER CO
80211-2560
US

IV. Provider business mailing address

3401 QUEBEC ST STE 5005
DENVER CO
80207-2341
US

V. Phone/Fax

Practice location:
  • Phone: 303-477-5303
  • Fax: 303-477-5302
Mailing address:
  • Phone: 303-322-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: