Provider Demographics
NPI:1871837138
Name:WILKINSON, JASON LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:LYNN
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2965 DEL REY PLZ
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1800
Mailing Address - Country:US
Mailing Address - Phone:719-229-6816
Mailing Address - Fax:
Practice Address - Street 1:8540 SCARBOROUGH DR STE 350
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7582
Practice Address - Country:US
Practice Address - Phone:719-590-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016583225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist