MEDICARE: DR. JESSICA LYNN SELOCK P.T., D.P.T., N.C.S.

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	2251P0200X	Pediatric Physical Therapist	029150-01	NY
2	225100000X	Physical Therapist	PTL0012968	CO

General Provider Information

NPI Number	:	1609058502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA LYNN SELOCK P.T., D.P.T., N.C.S.

Provider Business Mailing Address
First Line	:	6685 S KELLERMAN WAY
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80016-6164
Country	:	US
Telephone Number	:	516-551-3385
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 QUEBEC ST BLDG 600
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80230-7144
Country	:	US
Telephone Number	:	303-341-0369
Fax Number	:	303-341-0866

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

Provider Enumeration Date	:	12/03/2007
Last Update Date	:	01/16/2026

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