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General NPI Number Information
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NPI Number | 1861261893
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Entity Type | Individual
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Provider Name | JAKE L LOMAS RPSGT, RST
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Gender | Male
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Dates
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Enumeration Date | 01/02/2024
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 15 W DRY CREEK CIR
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City | LITTLETON
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State | CO
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Zip | 80120-4485
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Country | US
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Telephone | 303-952-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 2581 CHANNEL DR
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-3005
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Country | US
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Telephone | 325-374-4021
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number | 26619
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License Number State |
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