Healthcare Provider Details

I. General information

NPI: 1194201855
Provider Name (Legal Business Name): WESLEY RICKMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 ELCHO AVE UNIT 2
CRESTED BUTTE CO
81224-9616
US

IV. Provider business mailing address

PO BOX 2222
CRESTED BUTTE CO
81224-2222
US

V. Phone/Fax

Practice location:
  • Phone: 970-235-0130
  • Fax:
Mailing address:
  • Phone: 970-235-0130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR.0007693
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: