Provider Demographics
NPI:1366463457
Name:JENNIFER MAY
Entity Type:Organization
Organization Name:JENNIFER MAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:720-535-9086
Mailing Address - Street 1:13618 E BETHANY PL
Mailing Address - Street 2:#304
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3659
Mailing Address - Country:US
Mailing Address - Phone:720-535-9086
Mailing Address - Fax:720-535-9086
Practice Address - Street 1:13618 E BETHANY PL
Practice Address - Street 2:#304
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3659
Practice Address - Country:US
Practice Address - Phone:720-535-9086
Practice Address - Fax:720-535-9086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI904-024225100000X
CO254261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Not Answered261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40014600Medicaid