Provider Demographics
NPI:1699187708
Name:BARRETT, JO
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10903 US HIGHWAY 285
Mailing Address - Street 2:#E203
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-7731
Mailing Address - Country:US
Mailing Address - Phone:303-838-8443
Mailing Address - Fax:303-838-7794
Practice Address - Street 1:10903 US HIGHWAY 285
Practice Address - Street 2:#E203
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-7731
Practice Address - Country:US
Practice Address - Phone:303-838-8443
Practice Address - Fax:303-838-7794
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0016348174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist