Provider Demographics
NPI:1720335482
Name:ANDERBERG, JANE ROSEANN (DPT)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ROSEANN
Last Name:ANDERBERG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 TRENTON ST
Mailing Address - Street 2:APT 411
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-2064
Mailing Address - Country:US
Mailing Address - Phone:641-750-4406
Mailing Address - Fax:
Practice Address - Street 1:8000 E PRENTICE AVE
Practice Address - Street 2:SUITE C1
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2744
Practice Address - Country:US
Practice Address - Phone:303-773-0771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-12
Last Update Date:2012-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00118752251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic