Provider Demographics
NPI:1548480296
Name:RYE, GREGORY N (DC)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:N
Last Name:RYE
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 1:430 E EISENHOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3958
Mailing Address - Country:US
Mailing Address - Phone:970-663-7009
Mailing Address - Fax:970-667-3401
Practice Address - Street 1:430 E EISENHOWER BLVD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3958
Practice Address - Country:US
Practice Address - Phone:970-663-7009
Practice Address - Fax:970-667-3401
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3222111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO47303Medicare ID - Type Unspecified
COU21228Medicare UPIN