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General NPI Number Information
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NPI Number | 1437685302
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Entity Type | Organization
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Legal Business Name | RYCAHAN INC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 230 N AVENUE D
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City | CLIFTON
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State | TX
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Zip | 76634-1620
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Country | US
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Telephone | 254-675-3078
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Fax | 254-675-3145
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Provider Business Mailing Address
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Address Line | 230 N AVENUE D
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City | CLIFTON
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State | TX
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Zip | 76634-1620
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Country | US
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Telephone | 254-675-3078
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Fax | 254-675-3145
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Authorized Official
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Title or Position | OWNER
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Name | DR. LEE A BERGREN
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Credential | D.C.
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Telephone | 22546753078
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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 |
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License Number State |
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