Individual
JACOB KENNETH WHEELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
2818 GRAND VISTA CIR, COLORADO SPRINGS, CO 80904-5242
(801) 215-9309
Mailing address
1873 W TRAVERSE PKWY STE E100, LEHI, UT 84048-5985
(801) 215-9309
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
03/03/2020
Last updated
06/10/2026
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