Provider Demographics
NPI:1386626984
Name:LAFORCE, JEANNINE BEAUMONT (PT)
Entity Type:Individual
Prefix:MRS
First Name:JEANNINE
Middle Name:BEAUMONT
Last Name:LAFORCE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:JEANNINE
Other - Middle Name:
Other - Last Name:BEAUMONT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1330 QUAIL LAKE LOOP
Mailing Address - Street 2:SUITE 100 PT WORKS PC CHEYENNE MOUNTAIN CLINIC
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4651
Mailing Address - Country:US
Mailing Address - Phone:719-579-0230
Mailing Address - Fax:719-579-0277
Practice Address - Street 1:1330 QUAIL LAKE LOOP
Practice Address - Street 2:SUITE 100 PT WORKS CHEYENNE MOUNTAIN CLINIC
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4651
Practice Address - Country:US
Practice Address - Phone:719-579-0230
Practice Address - Fax:719-579-0277
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO6362225100000X, 2251S0007X, 2251X0800X, 225X00000X
CAPT17204225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist