Provider Demographics
NPI:1417001868
Name:TURNER, THOMAS MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:TURNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 BROADWAY ST.
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-6219
Mailing Address - Country:US
Mailing Address - Phone:303-938-0388
Mailing Address - Fax:303-938-3089
Practice Address - Street 1:1640 BROADWAY ST.
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-6219
Practice Address - Country:US
Practice Address - Phone:303-938-0388
Practice Address - Fax:303-938-3089
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO4130111NI0900X
CACO4130111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111NI0900XChiropractic ProvidersChiropractorInternist
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
COT90491Medicaid
CO14893Medicare ID - Type Unspecified