Provider Demographics
NPI:1902121023
Name:GEBHARDT, RYAN DUKE (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:DUKE
Last Name:GEBHARDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR-6382111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor