is a Specialist in Thornton, Colorado. practices all healthcare services and medical treatments related to Specialist. The NPI Number for is 1912117839. The last update date is .
's current location address is 2427 E 137th Ave, Thornton, Colorado. You can contact this provider via phone number 3039207169. The mailing address for is 2427 E 137th Ave, Thornton, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 2427 E 137th Ave, Thornton, Colorado |
| Phone Number | 3039207169 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1912117839 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 2427 E 137th Ave |
|---|---|
| City | Thornton |
| State | Colorado (CO) |
| Post Code | 806027249 |
| Phone Number | 3039207169 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 9204 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 23150751 | CO | -- |
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