=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811800824
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRYAN HANDWORK PSYCHIATRIC SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2026
-----------------------------------------------------
Last Update Date | 09/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 825 S BROADWAY ST
-----------------------------------------------------
City | BOULDER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80305-5963
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-893-8531
-----------------------------------------------------
Fax | 303-535-6474
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 825 S BROADWAY ST
-----------------------------------------------------
City | BOULDER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80305-5963
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-893-8531
-----------------------------------------------------
Fax | 303-535-6474
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN ASSOCIATE
-----------------------------------------------------
Name | MR. BRYAN HANDWORK
-----------------------------------------------------
Credential | PA-C
-----------------------------------------------------
Telephone | 720-893-8531
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------