Individual
MR. JASON R VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2121 E HARMONY RD, STE 330, FORT COLLINS, CO 80528-3400
(970) 624-4439
Mailing address
2121 E HARMONY RD, STE 330, FORT COLLINS, CO 80528-3400
(970) 624-4439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2491
CO
363AM0700X
Medical Physician Assistant
2491
CO
363AS0400X
Surgical Physician Assistant
2491
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43529577
—
CO
Enumeration date
09/13/2007
Last updated
12/26/2014
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