Provider Demographics
NPI:1053282582
Name:ROMERO, JENNIFER N (LMT, PTA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:N
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LMT, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-2135
Mailing Address - Country:US
Mailing Address - Phone:719-900-1605
Mailing Address - Fax:
Practice Address - Street 1:2175 ACADEMY CIR STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1682
Practice Address - Country:US
Practice Address - Phone:719-571-9498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0025826225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist