Organization
FRONTIER FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYCE THACKER DNP, FNP-BC, PMHNP (OWNER)
(888) 925-5859
Entity
Organization
Contact information
Practice address
4598 CR 60, BURLINGTON, CO 80807-1356
(888) 925-5254
(833) 784-1528
Mailing address
393 ELDRIDGE ST, BURLINGTON, CO 80807-1356
(719) 343-5388
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/26/2021
Last updated
06/02/2022
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