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General NPI Number Information
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NPI Number | 1568605897
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Entity Type | Individual
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Provider Name | JENNIFER ELIZABETH DAVIS PTA
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Gender | Female
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Dates
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Enumeration Date | 04/16/2009
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Last Update Date | 07/14/2011
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Provider Practice Location Address
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Address Line | 7100 W 13TH AVE
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City | LAKEWOOD
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State | CO
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Zip | 80626
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Country | US
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Telephone | 303-770-4682
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Fax |
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Provider Business Mailing Address
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Address Line | 7815 ALLISON WAY #105
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City | ARVADA
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State | CO
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Zip | 80005
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Country | US
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Telephone | 970-539-0831
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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 | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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License Number State |
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