Provider Demographics
NPI:1003009366
Name:THOMAS, WAYNE C (ATC)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:C
Last Name:THOMAS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
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Mailing Address - Street 1:6979 S HOLLY CIR
Mailing Address - Street 2:STE 105
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1577
Mailing Address - Country:US
Mailing Address - Phone:303-694-2295
Mailing Address - Fax:303-694-1843
Practice Address - Street 1:660 GOLDEN RIDGE RD
Practice Address - Street 2:STE 130
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-9541
Practice Address - Country:US
Practice Address - Phone:303-275-2190
Practice Address - Fax:303-275-2191
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer