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General NPI Number Information
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NPI Number | 1205977030
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Entity Type | Individual
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Provider Name | TIMOTHY WILLIAM RAY D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 421 21ST AVE SUITE 40
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City | LONGMONT
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State | CO
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Zip | 80501-1469
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Country | US
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Telephone | 303-776-5520
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Fax | 303-776-5522
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Provider Business Mailing Address
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Address Line | 421 21ST AVE SUITE 40
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City | LONGMONT
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State | CO
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Zip | 80501-1469
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Country | US
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Telephone | 303-776-5520
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Fax | 303-776-5522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 1358
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 1358
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License Number State | CO
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