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General NPI Number Information
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NPI Number | 1295166072
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Entity Type | Organization
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Legal Business Name | JENNIFER STROH DO FAMILY MEDICINE
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Dates
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Enumeration Date | 12/04/2013
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Last Update Date | 10/02/2015
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Provider Practice Location Address
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Address Line | 2139 N 12TH ST SUITE 2
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-2901
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Country | US
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Telephone | 970-256-1664
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Fax | 970-256-1707
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Provider Business Mailing Address
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Address Line | 2139 N 12TH ST SUITE 2
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-2901
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Country | US
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Telephone | 970-256-1664
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Fax | 970-256-1707
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNIFER STROH
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Credential | D.O.
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Telephone | 970-256-1664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 41942
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License Number State | CO
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