Individual
DR. JAY DALE BREITLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
600 S AIRPORT RD, BUILDING C, SUITE C, LONGMONT, CO 80503-6424
(804) 366-5461
Mailing address
600 S AIRPORT RD, BUILDING C, SUITE C, LONGMONT, CO 80503-6424
(804) 366-5461
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.011566
IL
Other
Enumeration date
12/02/2009
Last updated
08/18/2010
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