Provider Demographics
NPI:1417047051
Name:GROOVER, THOMAS DREW (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DREW
Last Name:GROOVER
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 1:2725 IRIS AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2433
Mailing Address - Country:US
Mailing Address - Phone:303-442-7772
Mailing Address - Fax:303-442-2426
Practice Address - Street 1:2725 IRIS AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-2433
Practice Address - Country:US
Practice Address - Phone:303-442-7772
Practice Address - Fax:303-442-2426
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4727111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation