Provider Demographics
NPI:1730239658
Name:LEUNG, TIM (MS, DC)
Entity type:Individual
Prefix:
First Name:TIM
Middle Name:
Last Name:LEUNG
Suffix:
Gender:M
Credentials:MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6265 E. EVANS AVE
Mailing Address - Street 2:UNIT 7
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5822
Mailing Address - Country:US
Mailing Address - Phone:303-692-8803
Mailing Address - Fax:303-692-8805
Practice Address - Street 1:6265 E. EVANS AVE
Practice Address - Street 2:UNIT 7
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5822
Practice Address - Country:US
Practice Address - Phone:303-692-8803
Practice Address - Fax:303-692-8805
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4977111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC477758Medicare ID - Type Unspecified