| Jacob Boese, | |
|
1551 Professional Ln Unit 145, Longmont, CO 80501-6968 | |
| (720) 494-3290 | |
| Not Available |
| Full Name | Jacob Boese |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 1551 Professional Ln Unit 145, Longmont, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942898028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | CP032830T (Washington) | Secondary |
| 225100000X | Physical Therapist | CP0369TT1 (Colorado) | Primary |
| Provider Name | Olympia Orthopaedic Associates Pllc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1083785398 PECOS PAC ID: 2365337508 Enrollment ID: O20040217001032 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Boese, 615 Lilly Rd Ne Ste 240, Olympia, WA 98506-5117 Ph: (360) 413-3850 | Jacob Boese, 1551 Professional Ln Unit 145, Longmont, CO 80501-6968 Ph: (720) 494-3290 |
Mr. Robert M Prater, PHYSICAL THEAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2059 Condor Ct, Longmont, CO 80503 Phone: 303-324-6242 | |
Healther Lynn Stokes, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1551 Professional Ln, #145, Longmont, CO 80501 Phone: 720-494-3290 Fax: 720-494-3294 | |
Crafted Physical Therapy Pllc Physical Therapist Medicare: Medicare Enrolled Practice Location: 701 Delaware Ave Unit E, Longmont, CO 80501 Phone: 720-204-4567 | |
Kathleen Marie Stupansky, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1551 Professional Ln, #145, Longmont, CO 80501 Phone: 720-494-3290 Fax: 720-494-3294 | |
Stephanie Marie Lyle Maxwell, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 395 S Pratt Pkwy, Longmont, CO 80501 Phone: 303-776-6200 | |
Mr. Jason Donald Main, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1610 Dry Creek Dr, Longmont, CO 80503 Phone: 720-494-4750 Fax: 720-494-4751 | |
Sarah Elisabeth Troicky, PT,DPT,ATC Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1380 Tulip St, Longmont, CO 80501 Phone: 303-485-4163 Fax: 303-485-4164 |