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Individual

JEROD T DAWSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1907 BOISE AVE, SUITE 1, LOVELAND, CO 80538-5016
(907) 663-2200
(907) 663-2201
Mailing address
1907 BOISE AVE, SUITE 1, LOVELAND, CO 80538-5016
(907) 663-2200
(907) 663-2201

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6194
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CO400062
MEDICARE INDIVIDUAL PTAN
CO
Enumeration date
03/12/2008
Last updated
02/27/2013
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