Healthcare Provider Details

I. General information

NPI: 1861709271
Provider Name (Legal Business Name): THOMAS NILES RUBINSON CNIM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2349 GLENARM PLACE
DENVER CO
80205
US

IV. Provider business mailing address

757 E. 20TH AVE SUITE 370 #831
DENVER CO
80205
US

V. Phone/Fax

Practice location:
  • Phone: 720-372-6751
  • Fax: 303-362-6615
Mailing address:
  • Phone: 720-372-6751
  • Fax: 303-362-6615

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:
Title or Position:
Credential:
Phone: