Provider Demographics
NPI:1013171529
Name:J MEDICAL INC
Entity Type:Organization
Organization Name:J MEDICAL INC
Other - Org Name:THERAHAND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-328-3332
Mailing Address - Street 1:12510 E ILIFF AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-6377
Mailing Address - Country:US
Mailing Address - Phone:303-564-5008
Mailing Address - Fax:
Practice Address - Street 1:4350 WADSWORTH BLVD STE 425
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4652
Practice Address - Country:US
Practice Address - Phone:303-564-5008
Practice Address - Fax:720-484-4329
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J MEDICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-14
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO79872760Medicaid
COA109120OtherMEDICARE PTAN