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General NPI Number Information
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NPI Number | 1336388305
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Entity Type | Organization
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Legal Business Name | GUNYAN FAMILY CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 02/13/2009
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Last Update Date | 02/13/2009
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Provider Practice Location Address
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Address Line | 456 KOKOPELLI BLVD UNIT B
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City | FRUITA
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State | CO
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Zip | 81521-8723
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Country | US
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Telephone | 970-250-2889
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Fax |
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Provider Business Mailing Address
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Address Line | 456 KOKOPELLI BLVD UNIT B
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City | FRUITA
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State | CO
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Zip | 81521-8723
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Country | US
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Telephone | 970-250-2889
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. RYAN LEE GUNYAN
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Credential | D.C., C.S.C.S.
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Telephone | 970-250-2889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6305
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License Number State | CO
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