Individual
JACQUELINE KAY ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
514 28 1/4 RD UNIT 1, GRAND JUNCTION, CO 81501-4961
(970) 242-8162
Mailing address
514 28 1/4 RD UNIT 1, GRAND JUNCTION, CO 81501-4961
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0015658
CO
Other
Enumeration date
02/27/2014
Last updated
02/27/2014
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