Healthcare Provider Details

I. General information

NPI: 1144155763
Provider Name (Legal Business Name): JACOB MATTHEW JENSEN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18260 LINCOLN AVE STE 107
PARKER CO
80134-9601
US

IV. Provider business mailing address

18260 LINCOLN AVE STE 107
PARKER CO
80134-9601
US

V. Phone/Fax

Practice location:
  • Phone: 303-414-2148
  • Fax: 303-414-2149
Mailing address:
  • Phone: 303-414-2148
  • Fax: 303-414-2149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number21365
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: