Provider Demographics
NPI:1649375130
Name:YOCHUM, TERRY R (DC, DACBR)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:R
Last Name:YOCHUM
Suffix:
Gender:M
Credentials:DC, DACBR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 745040
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80006-5040
Mailing Address - Country:US
Mailing Address - Phone:303-940-9400
Mailing Address - Fax:303-940-9600
Practice Address - Street 1:7500 WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2763
Practice Address - Country:US
Practice Address - Phone:303-940-9400
Practice Address - Fax:303-940-9600
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2228111NR0200X
MI4625111NR0200X
IL038.003452111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOB4857Medicare PIN