Individual
MRS. JEANETTE LOUISE WOLFE PIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
119 BASTILLE DR, PAGOSA SPRINGS, CO 81147-9388
(970) 731-4330
Mailing address
PO BOX 58, CHROMO, CO 81128-0058
(970) 749-4155
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
105735-4201
UT
225X00000X
Occupational Therapist
Primary
1126
CO
Other
Enumeration date
11/16/2010
Last updated
11/16/2010
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