Healthcare Provider Details

I. General information

NPI: 1356483358
Provider Name (Legal Business Name): MAUREEN M THOMM D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W SOUTH BOULDER RD SUITE 2
LOUISVILLE CO
80027-1673
US

IV. Provider business mailing address

335 W SOUTH BOULDER RD SUITE 1
LOUISVILLE CO
80027-1196
US

V. Phone/Fax

Practice location:
  • Phone: 303-604-4358
  • Fax:
Mailing address:
  • Phone: 303-604-4358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5684
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: