Individual
JACOB A. WEIRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2635 N 7TH ST, GRAND JUNCTION, CO 81501
(970) 298-2551
Mailing address
2635 N 7TH ST, GRAND JUNCTION, CO 81501-8209
(970) 298-2551
(970) 298-2818
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5823
AZ
363A00000X
Physician Assistant
Primary
PA.0004273
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22506080
—
CO
01
—
553172YYS0
MEDICARE B FOR MOUNTAIN PEAKS URGENT CARE
CO
Enumeration date
09/18/2014
Last updated
05/10/2019
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