Provider Demographics
NPI:1710387832
Name:PIPAL, JESSICA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:PIPAL
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 1:2737 W 23RD AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5144
Mailing Address - Country:US
Mailing Address - Phone:630-664-2073
Mailing Address - Fax:
Practice Address - Street 1:6767 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-8002
Practice Address - Country:US
Practice Address - Phone:303-703-3499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist