Individual
RUTH A PROCHASKA-JACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(720) 536-6966
Mailing address
4335 E 118TH PL, THORNTON, CO 80233-1732
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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