Provider Demographics
NPI:1528464302
Name:SCHUCK, KRISTA (DC)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:SCHUCK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 DAGNY WAY
Mailing Address - Street 2:STE 210
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-8013
Mailing Address - Country:US
Mailing Address - Phone:303-604-2987
Mailing Address - Fax:303-604-2997
Practice Address - Street 1:2770 DAGNY WAY
Practice Address - Street 2:STE 210
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8013
Practice Address - Country:US
Practice Address - Phone:303-604-2987
Practice Address - Fax:303-604-2997
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor