Individual
JENNIFER SUZANNE BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1020 PATTON ST, FORT COLLINS, CO 80524-4018
(970) 484-7981
Mailing address
4125 SADDLE NOTCH DR, FORT COLLINS, CO 80526-3572
(970) 231-3338
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0012574
CO
Other
Enumeration date
05/07/2022
Last updated
05/07/2022
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