Provider Demographics
NPI:1609058502
Name:SELOCK, JESSICA LYNN (PT, DPT, NCS)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LYNN
Last Name:SELOCK
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6685 S KELLERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-6164
Mailing Address - Country:US
Mailing Address - Phone:516-551-3385
Mailing Address - Fax:
Practice Address - Street 1:200 QUEBEC ST BLDG 600
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7144
Practice Address - Country:US
Practice Address - Phone:303-341-0369
Practice Address - Fax:303-341-0866
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029150-012251P0200X
COPTL0012968225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics