Individual
THOMAS CHARLES INGERSOLL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
275 SOUTH ASPEN ST, STOP 89, BUCKLEY SFB, CO 80011
(720) 847-7404
Mailing address
6900 ALDEN DR, FE WARREN AFB, WY 82005-3906
(307) 773-3840
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/16/2017
Last updated
11/14/2023
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