Provider Demographics
NPI:1104501840
Name:YEATON, JESSICA JANE (PT, DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:JANE
Last Name:YEATON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:586 FOREST VIEW DR
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-3171
Mailing Address - Country:US
Mailing Address - Phone:907-244-6514
Mailing Address - Fax:
Practice Address - Street 1:1024 CENTRAL PARK DR
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8813
Practice Address - Country:US
Practice Address - Phone:970-871-2370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0018918225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist