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NPI Code Detail

MEDICARE: JESSICA VALETA MS, LAT, ATC

MEDICARE: JESSICA VALETA MS, LAT, ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1003599812
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA VALETA MS, LAT, ATC
Provider Business Mailing Address
First Line : 751 S HOLLY ST
Second Line :
City : DENVER
State : CO
Zip : 80246-2301
Country : US
Telephone Number : 303-946-3305
Fax Number :
Provider Business Practice Location Address
First Line : 2242 W 29TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80211-3804
Country : US
Telephone Number : 303-718-3435
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2023
Last Update Date : 08/08/2023

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