Individual
DR. JESSICA LYNN GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATC
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4000
Mailing address
1289 N STARKWEATHER LN, PUEBLO, CO 81007-3901
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL.0012693
CO
2255A2300X
Athletic Trainer
2000003893
CO
Other
Enumeration date
08/11/2017
Last updated
08/11/2017
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