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Individual

JULIE RAE JENNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
550 E 3RD AVE APT 104, DENVER, CO 80203-4101
(469) 644-4467
Mailing address
1165 CANAL AVE, IDAHO FALLS, ID 83402-2864
(469) 644-4467

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0015941
CO
225100000X
Physical Therapist
Primary
PT-7471
ID

Other

Enumeration date
10/18/2018
Last updated
08/11/2021
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