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General NPI Number Information
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NPI Number | 1437354719
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Entity Type | Individual
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Provider Name | JENNIFER CHUDY SHEPHERD MSPT, CFMT, FAAOMPT
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Gender | Female
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 1800 JACKSON ST STE 208
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City | GOLDEN
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State | CO
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Zip | 80401-2358
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Country | US
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Telephone | 720-270-5022
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Fax |
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Provider Business Mailing Address
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Address Line | 7 TWILIGHT DR
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City | WHEAT RIDGE
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State | CO
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Zip | 80215-6648
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Country | US
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Telephone | 720-270-5022
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6837
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License Number State | CO
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