Provider Demographics
NPI:1629763032
Name:PYRC, JONATHON
Entity Type:Individual
Prefix:MR
First Name:JONATHON
Middle Name:
Last Name:PYRC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JONNY
Other - Middle Name:
Other - Last Name:PYRC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:422 ATWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-5517
Mailing Address - Country:US
Mailing Address - Phone:720-779-6315
Mailing Address - Fax:
Practice Address - Street 1:3030 S COLLEGE AVE UNIT 207
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2557
Practice Address - Country:US
Practice Address - Phone:970-239-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health