Basic Information
| Provider Information | |||||||||
| NPI: | 1578710273 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WINKEL | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | EVE | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7310 S ALTON WAY | ||||||||
| Address2: | STE 6L | ||||||||
| City: | CENTENNIAL | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801122334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037904495 | ||||||||
| FaxNumber: | 7204881988 | ||||||||
| Practice Location | |||||||||
| Address1: | 56171 EAST COLFAX AVENUE | ||||||||
| Address2: | UNIT 6, | ||||||||
| City: | STRASBURG | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036226688 | ||||||||
| FaxNumber: | 3036226687 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2008 | ||||||||
| LastUpdateDate: | 12/17/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT 10097 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.