Organization
COLIN TKACHUK
Active
Other names
Optimum Chiropractic and Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
COLIN TKACHUK DC (CHIROPRACTOR)
(817) 481-9339
Entity
Organization
Contact information
Practice address
6224 COLLEYVILLE BLVD, SUITE B, COLLEYVILLE, TX 76034-6276
(817) 481-9339
(817) 481-9669
Mailing address
6224 COLLEYVILLE BLVD, SUITE B, COLLEYVILLE, TX 76034-6276
(817) 481-9339
(817) 481-9669
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
9771
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
608079
BLUE CROSS BLUE SHIELD
TX
01
—
9771
PROF LICENSE #
TX
01
—
P00366997
RAILROAD MEDICARE
TX
Enumeration date
09/13/2006
Last updated
06/16/2008
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