Individual
MR. JAE JOON MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
2600 S PARKER RD STE 135, AURORA, CO 80014-1603
(303) 283-0130
(303) 283-0131
Mailing address
2600 S PARKER RD STE 135, AURORA, CO 80014-1603
(303) 283-0130
(303) 283-0131
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7596
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881822930
NPI GROUP NUMBER
CO
01
—
527268
MEDICARE PROVIDER NUMBER
CO
Enumeration date
07/16/2008
Last updated
06/29/2009
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