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NPI Code Detail

MEDICARE: JESSICA HENDRY CODY PT

MEDICARE: JESSICA HENDRY CODY PT
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
1225100000XPhysical TherapistGA

General Provider Information

NPI Number : 1104292069
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA HENDRY CODY PT
Provider Business Mailing Address
First Line : 7340 S ALTON WAY STE 11-D
Second Line :
City : CENTENNIAL
State : CO
Zip : 80112-2323
Country : US
Telephone Number : 720-493-1181
Fax Number : 720-493-1191
Provider Business Practice Location Address
First Line : 2418 E BRIDGE ST
Second Line :
City : BRIGHTON
State : CO
Zip : 80601-2546
Country : US
Telephone Number : 303-655-8699
Fax Number : 303-655-8698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2015
Last Update Date : 04/10/2019

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