Provider Demographics
NPI:1215913769
Name:HALE-HELPS, JYTTE EVELYN (PT)
Entity type:Individual
Prefix:
First Name:JYTTE
Middle Name:EVELYN
Last Name:HALE-HELPS
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:PO BOX 168
Mailing Address - Street 2:
Mailing Address - City:LA VETA
Mailing Address - State:CO
Mailing Address - Zip Code:81055-0168
Mailing Address - Country:US
Mailing Address - Phone:719-742-5474
Mailing Address - Fax:719-742-5474
Practice Address - Street 1:815 SOUTH OAK STREET
Practice Address - Street 2:
Practice Address - City:LA VETA
Practice Address - State:CO
Practice Address - Zip Code:81055-0168
Practice Address - Country:US
Practice Address - Phone:719-742-5474
Practice Address - Fax:719-742-5474
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-16
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36022251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO49479768Medicaid