Provider Demographics
NPI:1477788768
Name:WANG, JENNY (PT, MS, DPT)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:PT, MS, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2736
Mailing Address - Country:US
Mailing Address - Phone:303-597-1724
Mailing Address - Fax:303-788-5469
Practice Address - Street 1:701 E HAMPDEN AVE
Practice Address - Street 2:SUITE 330
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2736
Practice Address - Country:US
Practice Address - Phone:303-597-1724
Practice Address - Fax:303-788-5469
Is Sole Proprietor?:No
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist