Organization
HIGHLANDS PHYSICIAL MEDICINE AND REHABILITATION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB P JACOB MD (OWNER)
(970) 619-3400
Entity
Organization
Contact information
Practice address
4100 UNION ST, LOVELAND, CO 80538
(970) 619-3400
Mailing address
1175 58TH AVE, STE 202, GREELEY, CO 80634-4807
(970) 495-0300
(970) 224-9624
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
43793
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20238061
—
CO
01
—
DE7212
RAILROAD MEDICARE
—
01
—
JA674614
ANTHEM BCBS
CO
Enumeration date
06/08/2006
Last updated
02/27/2008
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