Healthcare Provider Details

I. General information

NPI: 1780547091
Provider Name (Legal Business Name): TUKER NIELSEN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

561 25 RD STE 104
GRAND JUNCTION CO
81505-1360
US

IV. Provider business mailing address

561 25 RD STE 104
GRAND JUNCTION CO
81505-1360
US

V. Phone/Fax

Practice location:
  • Phone: 970-989-9219
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR.0009015
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: