Provider Demographics
NPI:1639739097
Name:HANDWORK, BRYAN CLIFFORD (PA-C)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:CLIFFORD
Last Name:HANDWORK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 ARAPAHOE AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1017
Mailing Address - Country:US
Mailing Address - Phone:720-340-7291
Mailing Address - Fax:
Practice Address - Street 1:3004 ARAPAHOE AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1017
Practice Address - Country:US
Practice Address - Phone:720-340-7291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0005615207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine