Provider Demographics
NPI:1033660410
Name:ELTING, JENNIFER J (LMT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J
Last Name:ELTING
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18062 E BELLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-2016
Mailing Address - Country:US
Mailing Address - Phone:303-503-6843
Mailing Address - Fax:
Practice Address - Street 1:2224 S FRASER ST
Practice Address - Street 2:SUITE 4
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4531
Practice Address - Country:US
Practice Address - Phone:720-539-5280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0002709225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist