Provider Demographics
NPI:1588341739
Name:DUERKSEN, JAKE (DO)
Entity type:Individual
Prefix:
First Name:JAKE
Middle Name:
Last Name:DUERKSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12505 W 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-5254
Mailing Address - Country:US
Mailing Address - Phone:303-237-9617
Mailing Address - Fax:303-237-6253
Practice Address - Street 1:12505 W 32ND AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-5254
Practice Address - Country:US
Practice Address - Phone:303-237-9617
Practice Address - Fax:303-237-6253
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008702111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor