Individual
JILLIAN ELISEQ BARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
311 MAPLETON AVE, BOULDER, CO 80304-3979
(303) 544-5758
Mailing address
837 E 17TH AVE APT 3G, DENVER, CO 80218-1469
(505) 570-1278
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11343
CO
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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