Individual
JACOB DANIEL SHIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1925 MOUNTAIN VIEW AVE FL 3, LONGMONT, CO 80501-3128
(720) 718-8240
(720) 718-0953
Mailing address
1925 MOUNTAIN VIEW AVE FL 3, LONGMONT, CO 80501-3128
(720) 718-8240
(720) 718-0953
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0009178
CO
363A00000X
Physician Assistant
PA-2185
ID
363A00000X
Physician Assistant
PA1128
WY
Other
Enumeration date
12/07/2021
Last updated
07/23/2025
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