Individual
JEREMY MICHAEL HALFACRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
559 S DATURA DR, PUEBLO WEST, CO 81007-1560
(914) 960-5039
Mailing address
559 S DATURA DR, PUEBLO WEST, CO 81007-1560
(914) 960-5039
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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