Basic Information
| Provider Information | |||||||||
| NPI: | 1720319635 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JARAMILLO | ||||||||
| FirstName: | ALEXANDRIA | ||||||||
| MiddleName: | |||||||||
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| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | VALDEZ | ||||||||
| OtherFirstName: | ALEXANDRIA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8200 S QUEBEC ST STE A6 | ||||||||
| Address2: | |||||||||
| City: | CENTENNIAL | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801123194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037706440 | ||||||||
| FaxNumber: | 3037706439 | ||||||||
| Practice Location | |||||||||
| Address1: | 8200 S QUEBEC ST STE A6 | ||||||||
| Address2: | |||||||||
| City: | CENTENNIAL | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801123194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037706440 | ||||||||
| FaxNumber: | 3037706439 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2010 | ||||||||
| LastUpdateDate: | 01/18/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | 4060 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
No ID Information.