Basic Information
| Provider Information | |||||||||
| NPI: | 1609313121 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUKLAREWICZ | ||||||||
| FirstName: | THOMAS | ||||||||
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| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1771 S QUEBEC WAY | ||||||||
| Address2: | P203 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802315697 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326163293 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10345 PARK GLENN WAY | ||||||||
| Address2: | SUITE # 220 | ||||||||
| City: | PARKER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038409202 | ||||||||
| FaxNumber: | 3038408928 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PTL0014418 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.