Individual
GREGORY A THWAITES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2001 70TH AVE, GREELEY, CO 80634-4621
(970) 392-2193
(970) 392-2193
Mailing address
2001 70TH AVE, GREELEY, CO 80634-4613
(970) 392-2193
(970) 392-2193
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2049
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07020498
—
CO
Enumeration date
06/15/2006
Last updated
09/24/2010
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