Individual
TY BRANDON NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 AIRPORT RD, RIFLE, CO 81650-8510
(970) 625-1510
(970) 625-6486
Mailing address
501 AIRPORT RD, RIFLE, CO 81650-8510
(970) 625-1510
(970) 625-6486
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DR.0058282
CO
Other
Enumeration date
05/24/2013
Last updated
09/24/2018
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