Healthcare Provider Details

I. General information

NPI: 1740822436
Provider Name (Legal Business Name): JEFF ROME PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 01/24/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

968 REESE STREET
SILVERTON CO
81433
US

IV. Provider business mailing address

PO BOX 822
SILVERTON CO
81433-0822
US

V. Phone/Fax

Practice location:
  • Phone: 913-244-3155
  • Fax:
Mailing address:
  • Phone: 913-244-3155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0016645
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: