Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 46362 | CO |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 510105436 | MI |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 46362 | CO |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 510105436 | MI |
NPI | 1245440510 |
---|---|
Provider Name | Dr. Thomas William Vavrek |
First Address | Aurora, CO 80012-6165 |
Second Address | Aurora, CO 80012-6165 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 09/12/2014 |