Healthcare Provider Details
I. General information
NPI: 1992288955
Provider Name (Legal Business Name): THE THERMOGRAM CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2018
Last Update Date: 09/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3000 CENTER GREEN DR STE 260
BOULDER CO
80301-2319
US
IV. Provider business mailing address
2295 ALPINE DR
ERIE CO
80516-4684
US
V. Phone/Fax
- Phone: 303-664-1139
- Fax: 303-664-1146
- Phone: 303-870-2659
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174H00000X |
| Taxonomy | Health Educator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 246Z00000X |
| Taxonomy | Other Specialist/Technologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
TIRZA
DERFLINGER
Title or Position: PRESIDENT
Credential: CTT
Phone: 303-664-1139