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THOMAS LAVERNE BACHINSKI PAC

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1679654909

Individual Registrant:
 THOMAS LAVERNE BACHINSKI PAC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
2101 KEN PRATT BLVD SUITE 104 LONGMONT, CO 80501-6567 US
Tel: 303-415-4157  Fax: 303-776-3102

Contact information for business:
5450 WESTERN AVE SUITE B BOULDER, CO 80301-2709 US
Tel: 303-415-4770  Fax: 303-415-4769

Registration Information:
NPI: 1679654909
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
COPA.0000246
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
COPA.0000246

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
07002462CO05




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