Healthcare Provider Details

I. General information

NPI: 1780513499
Provider Name (Legal Business Name): CORA HOLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 GRANT ST
THORNTON CO
80229-2155
US

IV. Provider business mailing address

9601 GRANT ST
THORNTON CO
80229-2155
US

V. Phone/Fax

Practice location:
  • Phone: 303-453-4972
  • Fax: 303-453-4985
Mailing address:
  • Phone: 303-453-4972
  • Fax: 303-453-4985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number245228
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: