Provider Demographics
NPI:1447619457
Name:JACK OF ALL TRADES LLC CO
Entity Type:Organization
Organization Name:JACK OF ALL TRADES LLC CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORUKHOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-297-7542
Mailing Address - Street 1:13057 E COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5322
Mailing Address - Country:US
Mailing Address - Phone:720-297-7542
Mailing Address - Fax:303-745-3393
Practice Address - Street 1:13057 E COLORADO AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5322
Practice Address - Country:US
Practice Address - Phone:720-297-7542
Practice Address - Fax:303-745-3393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-18
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2016105374600CL171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty