Provider Demographics
NPI:1104595305
Name:ARSENULT, JAKE (DPT)
Entity type:Individual
Prefix:
First Name:JAKE
Middle Name:
Last Name:ARSENULT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6662 W HAMILTON DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5337
Mailing Address - Country:US
Mailing Address - Phone:703-463-6099
Mailing Address - Fax:
Practice Address - Street 1:15235 E 38TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-1239
Practice Address - Country:US
Practice Address - Phone:303-340-3053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic