Provider Demographics
NPI:1669821153
Name:RASOR, JENNIFER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:RASOR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28408 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-8600
Mailing Address - Country:US
Mailing Address - Phone:715-347-6629
Mailing Address - Fax:
Practice Address - Street 1:26367 CONIFER RD
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-9140
Practice Address - Country:US
Practice Address - Phone:303-838-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013930225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist