Provider Demographics
NPI:1811666555
Name:PENG, JEFFREY WEI (DPT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:WEI
Last Name:PENG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10710 WESTMINSTER BLVD UNIT 120
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80020-4182
Mailing Address - Country:US
Mailing Address - Phone:303-593-0696
Mailing Address - Fax:
Practice Address - Street 1:10710 WESTMINSTER BLVD UNIT 120
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80020-4182
Practice Address - Country:US
Practice Address - Phone:303-593-0696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0017873225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist