Individual
JASON PICKERILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2790 N ACADEMY BLVD STE 250, COLORADO SPRINGS, CO 80917-5328
(719) 387-7775
(303) 223-0084
Mailing address
16270 FOREST LIGHT DR, COLORADO SPRINGS, CO 80908-2074
(719) 644-1119
(719) 208-7730
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2435
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04A663
MEDICARE
CO
05
—
16653254
—
CO
05
—
9000153835
—
CO
Enumeration date
04/14/2011
Last updated
06/11/2019
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