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Individual

JACQUELIN PANNEBAKKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12123 E 16TH AVENUE, AURORA, CO 80045
(720) 777-2233
Mailing address
765 S LAFAYETTE DR APT 152, LAFAYETTE, CO 80026-3568
(717) 943-5808

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0013703
CO

Other

Enumeration date
01/26/2017
Last updated
01/26/2017
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