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General NPI Number Information
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NPI Number | 1225278484
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Entity Type | Organization
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Legal Business Name | JUST FOR KIDS PEDIATRIC THERAPY
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 03/02/2009
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Provider Practice Location Address
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Address Line | 7703 S JACKSON CIR
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City | CENTENNIAL
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State | CO
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Zip | 80122-3518
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Country | US
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Telephone | 208-870-9811
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Fax |
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Provider Business Mailing Address
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Address Line | 7703 S JACKSON CIR
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City | CENTENNIAL
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State | CO
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Zip | 80122-3518
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Country | US
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Telephone | 208-870-9811
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | STACIE ANN LEWIS
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Credential | OTR
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Telephone | 208-870-9811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 831
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License Number State | CO
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