MEDICARE: JESSICA KLAIN 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
1	225100000X	Physical Therapist	10403	CO

General Provider Information

NPI Number	:	1306073580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA KLAIN PT

Provider Business Mailing Address
First Line	:	1554 VINE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-1322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1554 VINE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-1322
Country	:	US
Telephone Number	:	303-801-8852
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2009
Last Update Date	:	03/21/2021

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