Provider Demographics
NPI:1679854525
Name:METCALF, JENNIFER (MSPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:METCALF
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:333 PARK AVE
Mailing Address - Street 2:#2
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-2514
Mailing Address - Country:US
Mailing Address - Phone:305-951-0981
Mailing Address - Fax:
Practice Address - Street 1:616 E HYMAN AVE
Practice Address - Street 2:#100
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-2391
Practice Address - Country:US
Practice Address - Phone:970-925-1808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10251225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist