Provider Demographics
NPI:1861095721
Name:RAMMELL, JARED (CPO)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:RAMMELL
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 S BANNOCK ST APT 105
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-3643
Mailing Address - Country:US
Mailing Address - Phone:208-258-4051
Mailing Address - Fax:
Practice Address - Street 1:14400 E JEWELL AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5689
Practice Address - Country:US
Practice Address - Phone:303-283-5435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist