Individual
JASON PETRASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(719) 333-5055
Mailing address
7865 CONIFER DR, COLORADO SPRINGS, CO 80920-4554
(719) 290-1965
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0013142
CO
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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