Provider Demographics
NPI:1881703692
Name:FARRIS, JAMIE L (PT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:FARRIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:L
Other - Last Name:MICHALSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8510 BRYANT ST STE 130
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3845
Mailing Address - Country:US
Mailing Address - Phone:720-497-6666
Mailing Address - Fax:720-497-6777
Practice Address - Street 1:8510 BRYANT ST STE 130
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3845
Practice Address - Country:US
Practice Address - Phone:720-497-6666
Practice Address - Fax:720-497-6777
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CO5576225100000X, 2251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO5576OtherLICENSE #