NPI 1053638049

Jay Wilson D.C. P.C.

Organisation Exclusive Provider Organization Boulder, CO

Practice location

Address: 1455 Yarmouth Ave STE 112, Boulder, CO 80304-4345
Phone: (303) 449-7414
Fax: (303) 449-2147

Authorised official

Name: Jay Wilson
Title: Owner
Phone: (303) 449-7414

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 2311 (CO)

Other Exclusive Provider Organization providers in Colorado →

Registry record

NPI: 1053638049
Entity type: Organization
NPI issued: 29 Apr 2010
Record last updated: 29 Apr 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.