Provider Demographics
NPI:1699360073
Name:J CO PHYSICAL THERAPY
Entity Type:Organization
Organization Name:J CO PHYSICAL THERAPY
Other - Org Name:MVMT LOFT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:405-290-8912
Mailing Address - Street 1:9445 CARLYLE PARK PL
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6977
Mailing Address - Country:US
Mailing Address - Phone:405-290-8912
Mailing Address - Fax:
Practice Address - Street 1:9445 CARLYLE PARK PL
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-6977
Practice Address - Country:US
Practice Address - Phone:405-290-8912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-08
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty