Frederick Albert Thayer PA-C

NPI 1669502563 - Physician Assistant - 363A00000X

NPI Details
NPI 1669502563
Gender Male
Enumeration Date 03/07/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
2141 N ACADEMY CIR
COLORADO SPRINGS CO, 80909-1691, US
Phone (719) 597-4200
Fax (719) 597-4495
Business Location
2141 N ACADEMY CIR
COLORADO SPRINGS CO, 80909-1691, US
Phone (719) 597-4200
Fax (719) 597-4495
Toxanomy
Taxonomy Code 363A00000X
License State Colorado
License Number 24
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According to our database, Frederick Albert Thayer PA-C NPI is 1669502563, taxonomy code is 363A00000X and license number is 24, license state is located at Colorado. Frederick Albert Thayer PA-C physically located at 2141 N Academy Cir, Colorado Springs CO, 80909-1691. NPI Number Frederick Albert Thayer PA-C has the Individual type.

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1669502563 NPI number is provided on an as is basis without warranty of any kind. 1669502563 is maintained by the National Plan & Provider Enumeration System. The contents of Frederick Albert Thayer PA-C are for informational purposes only.