Provider Demographics
NPI:1215255211
Name:O'MEARA, JAMIE L (PT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:O'MEARA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 S. PARKER RD
Mailing Address - Street 2:SUITE 615
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-0000
Mailing Address - Country:US
Mailing Address - Phone:303-755-3170
Mailing Address - Fax:303-755-3217
Practice Address - Street 1:2821 S. PARKER RD
Practice Address - Street 2:SUITE 615
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-0000
Practice Address - Country:US
Practice Address - Phone:303-755-3170
Practice Address - Fax:303-755-3217
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist