NPI 1316421704

Jacob Thompson

Practitioner Home Delivered Meals Longmont, CO

Practice location

Address: 650 Weaver Park Rd, Longmont, CO 80501-6000
Phone: (360) 513-8579
Mailing address: 1454 Alpine St, Longmont, CO 80504-3062

Registered specialties

Home Delivered Meals Primary

Suppliers Taxonomy 332U00000X Licence 46-5233699 (CO)

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Registry record

NPI: 1316421704
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Sep 2018
Record last updated: 20 Sep 2018

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.