Provider Demographics
NPI:1720392236
Name:AUSTIN, JENNIFER (PT, MPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:ERVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, MPT
Mailing Address - Street 1:5445 DTC PKWY STE 1130
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3038
Mailing Address - Country:US
Mailing Address - Phone:720-749-5599
Mailing Address - Fax:720-925-5897
Practice Address - Street 1:15901 E BRIARWOOD CIR UNIT 150
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1787
Practice Address - Country:US
Practice Address - Phone:303-645-4363
Practice Address - Fax:720-925-5897
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4320225100000X
CO12109225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist