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Individual

ADAM JENNINGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
3676 PARKER BLVD, SUITE 370, PUEBLO, CO 81008-2212
(719) 553-2209
Mailing address
PO BOX 9000, PUEBLO, CO 81008-9000
(719) 553-2209

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL0012902
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTL0012902
STATE LICENSE
CO
Enumeration date
08/26/2014
Last updated
08/26/2014
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