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General NPI Number Information
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NPI Number | 1992842884
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Entity Type | Organization
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Legal Business Name | GARY RADEMACHER PC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1050 17TH ST # B197
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City | DENVER
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State | CO
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Zip | 80265-1050
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Country | US
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Telephone | 303-292-9992
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Fax | 303-292-9970
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Provider Business Mailing Address
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Address Line | 1050 17TH ST # B197
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City | DENVER
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State | CO
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Zip | 80265-1050
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Country | US
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Telephone | 303-292-9992
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Fax | 303-292-9970
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | GARY M RADEMACHER
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Credential | DC
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Telephone | 303-292-9992
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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-4174
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License Number State | CO
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