Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | CO6362 | CO |
N | 225100000X | Physical Therapist | PT17204 | CA |
N | 2251S0007X | Physical Therapist - Sports | CO6362 | CO |
N | 2251X0800X | Physical Therapist - Orthopedic | CO6362 | CO |
N | 225X00000X | Occupational Therapist | CO6362 | CO |
NPI | 1386626984 |
---|---|
Provider Name | Mrs. Jeannine Beaumont Laforce |
First Address | Colorado Springs, CO 80906-4651 |
Second Address | Colorado Springs, CO 80906-4651 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 08/07/2007 |