Basic Information
| Provider Information | |||||||||
| NPI: | 1588774079 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBINSON | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | E. | ||||||||
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| NameSuffix: | JR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12 MOUNTAIN PINE DR | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801273565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039321269 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3555 LUTHERAN PKWY | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | WHEAT RIDGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800336021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034238334 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 09/30/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 4871 | 01 | CO | LICENSE # | OTHER |