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NPI Code Detail

MEDICARE: WHITNEY REAGAN JACKSON DPT

MEDICARE: WHITNEY REAGAN JACKSON DPT
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 TherapistCP024280TCO

General Provider Information

NPI Number : 1578966222
Entity Type Code : Individual
Provider Name (Legal Business Name) : WHITNEY REAGAN JACKSON DPT
Provider Business Mailing Address
First Line : 838 W DRAKE RD STE 105
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-5539
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 838 W DRAKE RD STE 105
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-5539
Country : US
Telephone Number : 970-449-1300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2014
Last Update Date : 10/20/2025

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Directions to “ WHITNEY REAGAN JACKSON DPT” Practice Location

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