Provider Demographics
NPI:1710665161
Name:ROCKY MOUNTAIN HYPERBARIC INSTITUTE -GUNNISON
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN HYPERBARIC INSTITUTE -GUNNISON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FULLMER
Authorized Official - Suffix:
Authorized Official - Credentials:CHT, CHS, SD
Authorized Official - Phone:303-478-5230
Mailing Address - Street 1:808 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2414
Mailing Address - Country:US
Mailing Address - Phone:970-641-0905
Mailing Address - Fax:303-666-2112
Practice Address - Street 1:808 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2414
Practice Address - Country:US
Practice Address - Phone:970-641-0905
Practice Address - Fax:303-666-2112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty