Healthcare Provider Details

I. General information

NPI: 1992931562
Provider Name (Legal Business Name): OPTIMUM HEALTH CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 06/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S COLORADO BLVD SUITE 300
GLENDALE CO
80246-1253
US

IV. Provider business mailing address

400 S COLORADO BLVD SUITE 300
GLENDALE CO
80246-1253
US

V. Phone/Fax

Practice location:
  • Phone: 720-974-0392
  • Fax:
Mailing address:
  • Phone: 720-974-0392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6065
License Number StateCO

VIII. Authorized Official

Name: DR. RYAN AUSTIN TUCHSCHERER
Title or Position: CHIROPRACTI PHYSICIAN/OWNER
Credential: D.C.
Phone: 720-974-0392