Provider Demographics
NPI:1700292646
Name:NEW, JOLEEN (MPT)
Entity Type:Individual
Prefix:
First Name:JOLEEN
Middle Name:
Last Name:NEW
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:JOLEEN
Other - Middle Name:
Other - Last Name:CARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:8600 PARK MEADOWS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2757
Mailing Address - Country:US
Mailing Address - Phone:303-649-2165
Mailing Address - Fax:
Practice Address - Street 1:8600 PARK MEADOWS DR STE 200
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2757
Practice Address - Country:US
Practice Address - Phone:303-649-2165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist