Individual
JACOB MCDONOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
5455 W 38TH AVE, WHEAT RIDGE, CO 80212-7251
(970) 214-8814
Mailing address
5172 QUITMAN ST, DENVER, CO 80212-2608
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0014353
CO
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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