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Individual

S.JASON MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
181 W MEADOW DR, VAIL, CO 81657-5242
(970) 479-5036
(970) 569-7453
Mailing address
PO BOX 270596, LOUISVILLE, CO 80027-5009
(970) 569-7478
(970) 569-7453

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2029
CO

Other

Enumeration date
03/26/2007
Last updated
12/22/2008
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