Individual
JORDAN FRED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
251 VIOLET ST STE 150, GOLDEN, CO 80401-6724
(303) 279-6000
Mailing address
251 VIOLET ST STE 150, GOLDEN, CO 80401-6724
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL.0012709
CO
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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