Provider Demographics
NPI:1902104144
Name:NILES, JAMI (PTA)
Entity Type:Individual
Prefix:MS
First Name:JAMI
Middle Name:
Last Name:NILES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:JAMI
Other - Middle Name:
Other - Last Name:KOEHLER FLEMINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:6859 KASSON DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-1523
Mailing Address - Country:US
Mailing Address - Phone:719-568-1355
Mailing Address - Fax:
Practice Address - Street 1:6859 KASSON DR
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-1523
Practice Address - Country:US
Practice Address - Phone:719-568-1355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-12
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant