Provider Demographics
NPI:1235460197
Name:GAWLINSKI, TRACIE
Entity Type:Individual
Prefix:
First Name:TRACIE
Middle Name:
Last Name:GAWLINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TRACIE
Other - Middle Name:
Other - Last Name:MILLAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6140 S GUN CLUB RD UNIT I-2
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5307
Mailing Address - Country:US
Mailing Address - Phone:303-680-5200
Mailing Address - Fax:303-680-2773
Practice Address - Street 1:6140 S GUN CLUB RD UNIT I-2
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-5307
Practice Address - Country:US
Practice Address - Phone:303-680-5200
Practice Address - Fax:303-680-2773
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3049225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist