Individual
JASON LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Contact information
Practice address
2139 ANDREWS ST, FORT COLLINS, CO 80528-7073
(970) 377-2605
Mailing address
2139 ANDREWS ST, FORT COLLINS, CO 80528-7073
(970) 377-2605
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
—
—
Other
Enumeration date
03/17/2011
Last updated
03/17/2011
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