Provider Demographics
NPI:1457325243
Name:VANOUS, ANDREW RONALD RAYMOND (ATC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:RONALD RAYMOND
Last Name:VANOUS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11673 W HORNSILVER MTN
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3235
Mailing Address - Country:US
Mailing Address - Phone:970-749-9197
Mailing Address - Fax:
Practice Address - Street 1:1500 ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-1887
Practice Address - Country:US
Practice Address - Phone:303-273-3575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer