Individual
MRS. JENNIFER LOUISE BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATC
Contact information
Practice address
7280 LAGAE RD, UNIT F, CASTLE ROCK, CO 80108
(720) 733-3655
(720) 733-3656
Mailing address
7280 LAGAE RD, UNIT F, CASTLE ROCK, CO 80108
(303) 663-5552
(303) 663-5554
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9754
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9754
STATE LICENSE
CO
Enumeration date
09/20/2007
Last updated
02/07/2014
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