Provider Demographics
NPI:1811353725
Name:REILLY, JAMIE DAWN (PT, DPT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:DAWN
Last Name:REILLY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:DAWN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6298 MONTEREY PL
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-3366
Mailing Address - Country:US
Mailing Address - Phone:405-474-7850
Mailing Address - Fax:
Practice Address - Street 1:8101 E LOWRY BLVD STE 230
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7195
Practice Address - Country:US
Practice Address - Phone:303-344-9090
Practice Address - Fax:303-344-1922
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0014633225100000X
OKPT5082225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist