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General NPI Number Information
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NPI Number | 1740722255
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Entity Type | Individual
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Provider Name | TY CHRISTOPHER CARZOLI D.C., M.S
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Gender | Male
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Dates
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Enumeration Date | 11/15/2016
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 1778 S BROADWAY
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City | DENVER
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State | CO
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Zip | 80210-3102
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Country | US
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Telephone | 904-229-6079
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Fax |
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Provider Business Mailing Address
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Address Line | 1778 S BROADWAY
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City | DENVER
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State | CO
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Zip | 80210-3102
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Country | US
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Telephone | 303-955-8270
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | EL.2786595
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHR.0007529
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License Number State | CO
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