Healthcare Provider Details

I. General information

NPI: 1992887244
Provider Name (Legal Business Name): JULIANA MARIE THOMAS RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 NORTH AVE
GRAND JUNCTION CO
81501-6428
US

IV. Provider business mailing address

649 MEADOWOOD ST
GRAND JUNCTION CO
81504-6977
US

V. Phone/Fax

Practice location:
  • Phone: 970-263-2804
  • Fax:
Mailing address:
  • Phone: 970-434-9971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number914
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: