Individual
JASON DOUGLAS MCCLINTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
85 W. MILL STREET, BAYFIELD, CO 81122
(970) 769-5320
Mailing address
82 DEER RIDGE DR, BAYFIELD, CO 81122-9418
(970) 769-5320
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3592
CO
Other
Enumeration date
01/12/2010
Last updated
01/12/2010
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