Provider Demographics
NPI:1255570123
Name:CURTIS, JORDAN LYNN EDGAR (MS OTR)
Entity type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:LYNN EDGAR
Last Name:CURTIS
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2769 E COUNTY ROAD 10 N
Mailing Address - Street 2:
Mailing Address - City:CENTER
Mailing Address - State:CO
Mailing Address - Zip Code:81125-9631
Mailing Address - Country:US
Mailing Address - Phone:719-271-6606
Mailing Address - Fax:
Practice Address - Street 1:10 RUPERT ST
Practice Address - Street 2:
Practice Address - City:MONTE VISTA
Practice Address - State:CO
Practice Address - Zip Code:81144-1042
Practice Address - Country:US
Practice Address - Phone:719-852-3742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-16
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0002305225XP0200X, 225X00000X, 225XP0019X
CO2305225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation