Healthcare Provider Details
I. General information
NPI: 1235277468
Provider Name (Legal Business Name): TODD SWANSON RT. RPA
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/01/2007
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2525 S DOWNING ST
DENVER CO
80210-5817
US
IV. Provider business mailing address
10800 E GEDDES AVE STE 300
ENGLEWOOD CO
80112-3895
US
V. Phone/Fax
- Phone: 303-761-9190
- Fax: 720-874-4462
- Phone: 303-761-9190
- Fax: 720-874-4462
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 247100000X |
| Taxonomy | Radiologic Technologist |
| License Number | 327973 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 243U00000X |
| Taxonomy | Radiology Practitioner Assistant |
| License Number | 07 CO 1296 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: