Most Relevant Information
Provider Data
| NPI Number: | 1003486879 |
| Provider Name: | JEFFREY JOSEPH MAXWELL PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | PTA.0014502 |
Most Important Dates
| Enumeration Date: | 06/25/2021 |
| Last Updated: | 06/25/2021 |
Provider Practice Location
12610 HUDSON ST
THORNTON
CO
802412302
Practice Location Phone/Fax
| Phone: | 4342093218 |
| Fax: |
Provider Mailing Location
12610 HUDSON ST
THORNTON
CO
802412302
Provider Mailing Phone/Fax
| Phone: | 4342093218 |
| Fax: |