Organization
TANYA TIVORSAK MD PC
Active
Organization
TANYA TIVORSAK MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA L TIVORSAK MD (OWNER)
(303) 440-1000
Entity
Organization
Contact information
Practice address
2425 CANYON BLVD STE 150, BOULDER, CO 80302-6736
(303) 440-1000
Mailing address
2425 CANYON BLVD STE 150, BOULDER, CO 80302-6736
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
50978
CO
Other
Enumeration date
08/07/2012
Last updated
01/09/2013
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