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Individual

REUBEN JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1217 BUTTONWOOD DR, FORT COLLINS, CO 80525-1911
(970) 305-6019
Mailing address
1217 BUTTONWOOD DR, FORT COLLINS, CO 80525-1911
(970) 305-6019

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0013262
CO

Other

Enumeration date
11/01/2013
Last updated
11/01/2013
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