Individual
JACQUELINE L HOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
3519 RICHMOND DR, FORT COLLINS, CO 80526-5995
(970) 204-0300
Mailing address
3519 RICHMOND DR, FORT COLLINS, CO 80526-5995
(970) 204-0300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/18/2013
Last updated
01/13/2020
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