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NPI Code Detail

MEDICARE: YASHA JAFFUEL

MEDICARE: YASHA JAFFUEL
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1164681086
Entity Type Code : Individual
Provider Name (Legal Business Name) : YASHA JAFFUEL
Provider Business Mailing Address
First Line : 12573 COUNTY ROAD 103
Second Line :
City : WALSENBURG
State : CO
Zip : 81089-9417
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 515 FAIRVIEW AVE
Second Line :
City : CANON CITY
State : CO
Zip : 81212-2863
Country : US
Telephone Number : 719-275-0665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2008
Last Update Date : 06/05/2008

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Directions to “ YASHA JAFFUEL ” Practice Location

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