Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251G0304X | Physical Therapist - Geriatrics | 11123 | CO |
N | 2251N0400X | Physical Therapist - Neurology | 11123 | CO |
N | 2251S0007X | Physical Therapist - Sports | 11123 | CO |
Y | 2251X0800X | Physical Therapist - Orthopedic | 11123 | CO |
NPI | 1518255975 |
---|---|
Provider Name | Dr. Jason Ross Winslow |
First Address | Loveland, CO 80538-4862 |
Second Address | Greeley, CO 80634-3207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2011 |
Last Update Date | 19/07/2011 |