Provider Demographics
NPI:1649563446
Name:JARGOWSKY, ROBERT ANDREW (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ANDREW
Last Name:JARGOWSKY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SAN CARLOS CT
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-2694
Mailing Address - Country:US
Mailing Address - Phone:719-251-3008
Mailing Address - Fax:719-564-9190
Practice Address - Street 1:2 SAN CARLOS CT
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81005-2694
Practice Address - Country:US
Practice Address - Phone:719-251-3008
Practice Address - Fax:719-564-9190
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO449225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist