Individual
SAMANTHA IRENE JAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
540 FRONT STREET, FAIRPLAY, CO 80440
(719) 836-1833
Mailing address
PO BOX 524, ALMA, CO 80420-0524
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
058963
CO
405300000X
Prevention Professional
MT.0017165
CO
Other
Enumeration date
04/27/2017
Last updated
04/27/2017
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