Individual
MR. JESUS JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1120 E ELIZABETH ST STE G2, FORT COLLINS, CO 80524-4044
(970) 493-9193
Mailing address
1120 E ELIZABETH ST STE G2, FORT COLLINS, CO 80524-4044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0007830
CO
363AM0700X
Medical Physician Assistant
PA.0007830
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/09/2022
Last updated
11/22/2023
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