Individual
JON GLENN SHICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO LLC
Contact information
Practice address
7850 VANCE DR, #185, ARVADA, CO 80003
(303) 423-0535
(303) 422-3881
Mailing address
7850 VANCE DR, #185, ARVADA, CO 80003
(303) 423-0535
(303) 422-3881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39612
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42004772
—
CO
Enumeration date
10/05/2006
Last updated
07/08/2007
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