Healthcare Provider Details

I. General information

NPI: 1396944880
Provider Name (Legal Business Name): TICOR MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 E ARAPAHOE RD STE 390
CENTENNIAL CO
80112-4028
US

IV. Provider business mailing address

14100 E ARAPAHOE RD STE 390
CENTENNIAL CO
80112-4028
US

V. Phone/Fax

Practice location:
  • Phone: 303-493-1928
  • Fax: 393-493-1927
Mailing address:
  • Phone: 303-493-1928
  • Fax: 393-493-1927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS CHARLES RIBOVICH
Title or Position: PRESIDENT
Credential: MD
Phone: 303-493-1928