Individual
JANICE LYLES VAN BOCKERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
777 BANNOCK ST, DENVER, CO 80204-4507
(720) 771-0134
Mailing address
777 BANNOCK ST, DENVER, CO 80204-4507
(720) 771-0134
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.0004171
CO
Other
Enumeration date
12/10/2014
Last updated
07/30/2024
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