Healthcare Provider Details

I. General information

NPI: 1740531680
Provider Name (Legal Business Name): JASON ALLEN SMITH OTR/L, CHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2012
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 E BELLEVIEW AVE SUITE #615
GREENWOOD VILLAGE CO
80111-2803
US

IV. Provider business mailing address

8200 EAST BELLEVIEW AVENUE SUITE #615
GREENWOOD VILLAGE CO
80111-2898
US

V. Phone/Fax

Practice location:
  • Phone: 303-694-3333
  • Fax: 303-694-9666
Mailing address:
  • Phone: 303-694-3333
  • Fax: 303-694-9666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number3290
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number13444720-4201
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: