Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 6065 | CO |
NPI | 1043409832 |
---|---|
Provider Name | Dr. Ryan Austin Tuchscherer |
First Address | Glendale, CO 80246-1238 |
Second Address | Glendale, CO 80246-1238 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2007 |
Last Update Date | 17/10/2007 |