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Individual

IAN MICHAEL JOLLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
911 CASTELLO AVE, FAIRPLAY, CO 80440-5094
(719) 836-2055
Mailing address
341 PANTHER CT, WOODLAND PARK, CO 80863-9031
(269) 932-8594

Taxonomy

Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
029078
CO

Other

Enumeration date
06/05/2025
Last updated
06/05/2025
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