Provider Demographics
NPI:1003873613
Name:EYRICH, JENNIFER LYNN (PTA ATC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNN
Last Name:EYRICH
Suffix:
Gender:F
Credentials:PTA ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 DELGANY ST UNIT 1448
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1757
Mailing Address - Country:US
Mailing Address - Phone:202-277-0284
Mailing Address - Fax:202-223-1738
Practice Address - Street 1:2121 DELGANY ST UNIT 1448
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1757
Practice Address - Country:US
Practice Address - Phone:202-277-0284
Practice Address - Fax:202-223-1738
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer