Provider Demographics
NPI:1326616350
Name:MCLAUGHLIN, JESSIE (DPT)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-2701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2695 N PARK DR
Practice Address - Street 2:UNIT 102
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026
Practice Address - Country:US
Practice Address - Phone:303-926-1796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist