Provider Demographics
NPI:1245577311
Name:BACHELDOR, JENNIFER SUE (RPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SUE
Last Name:BACHELDOR
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3312 S OURAY WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-2034
Mailing Address - Country:US
Mailing Address - Phone:303-680-4983
Mailing Address - Fax:
Practice Address - Street 1:656 DILLON WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6803
Practice Address - Country:US
Practice Address - Phone:303-344-0636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1429225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist