Individual
JILL LINETTE ZUPANCIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 PHAY AVE, CANON CITY, CO 81212-2303
(719) 242-6023
Mailing address
1401 PHAY AVE, CANON CITY, CO 81212-2303
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0012140
CO
Other
Enumeration date
10/28/2018
Last updated
10/28/2018
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