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General NPI Number Information
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NPI Number | 1306030861
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Entity Type | Organization
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Legal Business Name | JILL STEDRONSKY MS, OTR, LLC
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 01/03/2011
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Provider Practice Location Address
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Address Line | 11832 W ASBURY PL
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City | LAKEWOOD
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State | CO
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Zip | 80228-4400
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Country | US
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Telephone | 303-332-9171
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Fax |
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Provider Business Mailing Address
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Address Line | 11832 W ASBURY PL
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City | LAKEWOOD
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State | CO
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Zip | 80228-4400
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. JILL MARGARET STEDRONSKY
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Credential | MS, OTR
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Telephone | 303-332-9171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 977159
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License Number State | CO
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