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General NPI Number Information
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NPI Number | 1356660955
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Entity Type | Organization
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Legal Business Name | GEBHARDT CHIROPRACTIC
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Dates
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Enumeration Date | 05/20/2010
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Last Update Date | 05/20/2010
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Provider Practice Location Address
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Address Line | 2280 S ALBION ST
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City | DENVER
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State | CO
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Zip | 80222-4906
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Country | US
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Telephone | 720-251-2201
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Fax |
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Provider Business Mailing Address
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Address Line | 1309 S ELM ST
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City | DENVER
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State | CO
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Zip | 80222-3521
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Country | US
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Telephone | 303-720-1487
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/SOLE OFFICER
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Name | DR. RYAN DUKE GEBHARDT
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Credential | D.C.
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Telephone | 303-720-1487
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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 | CHR-6382
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License Number State | CO
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