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Individual

TE JAH PEMBERTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2853 NORTH AVE, GRAND JUNCTION, CO 81501-5040
(970) 256-9424
Mailing address
8600 CREEDE TRL, FORT WORTH, TX 76118-7800

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
02/06/2023
Last updated
02/06/2023
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Product
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