Individual
SOPHIA JULIA JAECKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2698 PATTERSON RD STE 100, GRAND JUNCTION, CO 81506-8211
(970) 298-2874
Mailing address
1880 DOVER ST, LAKEWOOD, CO 80215-3187
(720) 243-2598
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0010212
CO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
0010212
CO
Other
Enumeration date
04/23/2024
Last updated
06/26/2024
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