Healthcare Provider Details

I. General information

NPI: 1811800824
Provider Name (Legal Business Name): BRYAN HANDWORK PSYCHIATRIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 S BROADWAY ST
BOULDER CO
80305-5963
US

IV. Provider business mailing address

825 S BROADWAY ST
BOULDER CO
80305-5963
US

V. Phone/Fax

Practice location:
  • Phone: 720-893-8531
  • Fax: 303-535-6474
Mailing address:
  • Phone: 720-893-8531
  • Fax: 303-535-6474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. BRYAN HANDWORK
Title or Position: PHYSICIAN ASSOCIATE
Credential: PA-C
Phone: 720-893-8531