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NPI Code Detail

MEDICARE: JAN M MEAD PT

MEDICARE:   JAN M MEAD  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 Therapist5427OR
2225100000XPhysical Therapist7825CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649311002
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAN M MEAD PT
Provider Business Mailing Address
First Line : 6930 OAK VALLEY LN
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-1513
Country : US
Telephone Number : 719-332-4580
Fax Number :
Provider Business Practice Location Address
First Line : 5747 N ACADEMY BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-3684
Country : US
Telephone Number : 541-575-4157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2007
Last Update Date : 01/10/2021

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Directions to “ JAN M MEAD PT” Practice Location

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