Provider Demographics
NPI:1043415938
Name:ONE ON ONE WELLNESS
Entity Type:Organization
Organization Name:ONE ON ONE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROTTLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:303-204-6404
Mailing Address - Street 1:9868 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-4350
Mailing Address - Country:US
Mailing Address - Phone:303-204-6404
Mailing Address - Fax:303-484-6289
Practice Address - Street 1:9868 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-4350
Practice Address - Country:US
Practice Address - Phone:303-204-6404
Practice Address - Fax:303-484-6289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3352225100000X, 2251E1200X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Not Answered2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomicsGroup - Single Specialty
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO3352OtherPHYSICAL THERAPY LICENSE