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1477203164
JACK RYAN HENDERSON
BOULDER, CO
NPI
1477203164
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-03-25
Last Update Date
2022-03-25
Business Address
JACK RYAN HENDERSON
4770 BASELINE RD STE 200
BOULDER, CO 80303-2668
Phone number: 970-982-3476
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Mailing Address
JACK RYAN HENDERSON
4770 BASELINE RD STE 200
BOULDER, CO 80303-2668
Phone number: 970-982-3476
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