Individual
JACOB SUNDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1505 S BRYAN AVE, FORT COLLINS, CO 80521-4408
(612) 401-7601
Mailing address
1505 S BRYAN AVE, FORT COLLINS, CO 80521-4408
(612) 401-7601
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0004913
CO
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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