Provider Demographics
NPI:1154968543
Name:TRELOAR, JENNA MARIE (ATC)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:MARIE
Last Name:TRELOAR
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7130 XAVIER ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80030-5746
Mailing Address - Country:US
Mailing Address - Phone:303-945-1553
Mailing Address - Fax:
Practice Address - Street 1:901 8TH ST S
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56562-0001
Practice Address - Country:US
Practice Address - Phone:218-299-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer