Provider Demographics
NPI:1760959555
Name:FOHRMAN, JINNA (OTR)
Entity Type:Individual
Prefix:
First Name:JINNA
Middle Name:
Last Name:FOHRMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:JINNA
Other - Middle Name:
Other - Last Name:BRIGGS-FOHRMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3612 MARINER LN
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3125
Mailing Address - Country:US
Mailing Address - Phone:970-691-2106
Mailing Address - Fax:
Practice Address - Street 1:3932 JOHN F KENNEDY PKWY UNIT 10F
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3085
Practice Address - Country:US
Practice Address - Phone:970-691-2106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0005700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist