Individual
MR. JON DAVID LAURITZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
7290 W 14TH AVE, LAKEWOOD, CO 80214-4725
(303) 232-8047
Mailing address
4851 INDEPENDENCE ST, SUITE 200, WHEAT RIDGE, CO 80033-6715
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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