Organization
EAGLE INTEGRATED MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN THOMAS AZELTINE DC (PRESIDENT)
(971) 322-9791
Entity
Organization
Contact information
Practice address
717A SYLVAN LAKE RD, EAGLE, CO 81631
(970) 328-1200
(970) 328-1600
Mailing address
PO BOX 2259, EAGLE, CO 81631-2259
(970) 328-1200
(970) 328-1600
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6195
CO
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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