Basic Information
Provider Information
NPI: 1063401834
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCNEES
FirstName: JAN
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4900 S MONACO ST
Address2: SUITE 210
City: DENVER
State: CO
PostalCode: 802373486
CountryCode: US
TelephoneNumber: 3032184260
FaxNumber: 3032184249
Practice Location
Address1: 14000 E ARAPAHOE RD
Address2: #160
City: CENTENNIAL
State: CO
PostalCode: 801124046
CountryCode: US
TelephoneNumber: 3032184260
FaxNumber: 3032184249
Other Information
ProviderEnumerationDate: 10/14/2005
LastUpdateDate: 04/05/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTL-2001COY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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