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General NPI Number Information
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NPI Number | 1568699072
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Entity Type | Organization
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Legal Business Name | JH PEDIATRIC PHYSICAL THERAPY
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Dates
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Enumeration Date | 06/11/2009
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Last Update Date | 06/11/2009
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Provider Practice Location Address
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Address Line | 385 LILAC CIR
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City | LOUISVILLE
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State | CO
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Zip | 80027-2633
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Country | US
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Telephone | 512-619-5953
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Fax |
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Provider Business Mailing Address
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Address Line | 385 LILAC CIR
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City | LOUISVILLE
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State | CO
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Zip | 80027-2633
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Country | US
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Telephone | 512-619-5953
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST / OWNER
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Name | JENNY HARRISON
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Credential | PT
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Telephone | 512-619-5953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 9577
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License Number State | CO
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