Individual
JONATHAN OLDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2955 BASELINE RD, BOULDER, CO 80303-2356
(303) 444-8707
(303) 444-8109
Mailing address
2955 BASELINE RD, BOULDER, CO 80303-2356
(303) 444-8707
(303) 444-8109
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6917
CO
225100000X
Physical Therapist
6917
CO
Other
Enumeration date
12/10/2007
Last updated
12/10/2007
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