Provider Demographics
NPI:1629389051
Name:BOVAY, JAMIE K (DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:K
Last Name:BOVAY
Suffix:
Gender:M
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 S BIRCH ST
Mailing Address - Street 2:# 110
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-3113
Mailing Address - Country:US
Mailing Address - Phone:573-528-2530
Mailing Address - Fax:
Practice Address - Street 1:9218 KIMMER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LONETREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6732
Practice Address - Country:US
Practice Address - Phone:303-792-7377
Practice Address - Fax:303-792-9077
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10821225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC477678Medicare PIN