Provider Demographics
NPI:1356660955
Name:GEBHARDT CHIROPRACTIC
Entity Type:Organization
Organization Name:GEBHARDT CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SOLE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:DUKE
Authorized Official - Last Name:GEBHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-720-1487
Mailing Address - Street 1:1309 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3521
Mailing Address - Country:US
Mailing Address - Phone:303-720-1487
Mailing Address - Fax:
Practice Address - Street 1:2280 S ALBION ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4906
Practice Address - Country:US
Practice Address - Phone:720-251-2201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR-6382111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty