Provider Demographics
NPI:1831147685
Name:WHALEN PRICE, JANE MICHELLE (PT)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:MICHELLE
Last Name:WHALEN PRICE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 E 134TH DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80241-1407
Mailing Address - Country:US
Mailing Address - Phone:303-252-7264
Mailing Address - Fax:
Practice Address - Street 1:1 DUETTE WAY
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1090
Practice Address - Country:US
Practice Address - Phone:303-398-1807
Practice Address - Fax:303-270-2238
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO2043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist