Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 4727 | CO |
N | 111NR0400X | Rehabilitation Chiropractor | 4727 | CO |
NPI | 1417047051 |
---|---|
Provider Name | Dr. Thomas Drew Groover |
First Address | Boulder, CO 80304-2433 |
Second Address | Boulder, CO 80304-2433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/07/2007 |