Individual
JASON YAOU ZHAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
6767 29TH ST, GREELEY, CO 80634-5474
(970) 652-2477
Mailing address
1405 16TH AVE, GREELEY, CO 80631-4534
(302) 345-0015
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
60531
OR
225100000X
Physical Therapist
Primary
PTL.0017689
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500670424
—
OR
Enumeration date
04/08/2014
Last updated
09/07/2021
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