Individual
JENNIFER L HIMOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 E PROSPECT RD, FORT COLLINS, CO 80525
(970) 493-0112
Mailing address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL.0007316
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120317700
—
WY
05
—
47154551
—
CO
01
—
P00685548
RR MEDICARE
CO
Enumeration date
11/22/2005
Last updated
08/16/2018
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