Provider Demographics
NPI:1255513081
Name:ENGLER, RONALD W (DC, PTA)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:W
Last Name:ENGLER
Suffix:
Gender:M
Credentials:DC, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2148 BROADWAY STE C3
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-1098
Mailing Address - Country:US
Mailing Address - Phone:970-243-5164
Mailing Address - Fax:
Practice Address - Street 1:2148 BROADWAY STE C3
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81507-1098
Practice Address - Country:US
Practice Address - Phone:970-243-5164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-04
Last Update Date:2016-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6170111N00000X, 111N00000X
TX12329111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC811287Medicare PIN