Provider Demographics
NPI:1033749619
Name:FELTES, JEFFREY S (HAD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:S
Last Name:FELTES
Suffix:
Gender:M
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 N ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3642
Mailing Address - Country:US
Mailing Address - Phone:719-296-6849
Mailing Address - Fax:719-296-6852
Practice Address - Street 1:2616 N ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3642
Practice Address - Country:US
Practice Address - Phone:719-296-6849
Practice Address - Fax:719-296-6852
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000333237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist