Provider Demographics
NPI:1851405963
Name:HRUBES, JEANETTE (PT)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:HRUBES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 S BROADWAY ST
Mailing Address - Street 2:STE 201
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5972
Mailing Address - Country:US
Mailing Address - Phone:303-402-9283
Mailing Address - Fax:
Practice Address - Street 1:805 S BROADWAY ST
Practice Address - Street 2:STE 201
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5972
Practice Address - Country:US
Practice Address - Phone:303-402-9283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9313225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist