Individual
DR. JEROME LANDBLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1925 W MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
(720) 494-3107
Mailing address
1925 W MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
(720) 494-3107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30664
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01306646
—
CO
Enumeration date
06/15/2005
Last updated
11/25/2014
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