Individual
JESSICA FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, PCS
Contact information
Practice address
801 MAIN ST, STE. 10, LOUISVILLE, CO 80027-1864
(303) 887-4466
(303) 957-1955
Mailing address
801 MAIN ST, STE. 10, LOUISVILLE, CO 80027-1864
(303) 887-4466
(303) 957-1955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8602
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48889733
—
CO
Enumeration date
02/27/2007
Last updated
04/24/2011
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