Provider Demographics
NPI:1700498953
Name:KASSNER, JORDAN K (LMT)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:K
Last Name:KASSNER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 S RIO GRANDE ST APT 6-304
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-8271
Mailing Address - Country:US
Mailing Address - Phone:307-286-4673
Mailing Address - Fax:
Practice Address - Street 1:1901 KIPLING ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-2822
Practice Address - Country:US
Practice Address - Phone:720-999-8550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist