| Canyon Ridge Integrative Health Llc | |
|
7280 Lagae Rd Ste B Castle Pines CO 80108-9454 | |
| (303) 660-3505 | |
| Not Available |
| Full Name | Canyon Ridge Integrative Health Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 7280 Lagae Rd Ste B, Castle Pines, Colorado |
| Authorized Official Name and Position | Bryan Rudiak (OWNER) |
| Authorized Official Contact | 3036603505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Ridge Integrative Health Llc 7280 Lagae Rd Ste B Castle Pines CO 80108-9454 Ph: (303) 660-3505 | Canyon Ridge Integrative Health Llc 7280 Lagae Rd Ste B Castle Pines CO 80108-9454 Ph: (303) 660-3505 |
| NPI Number | 1497451355 |
|---|---|
| Provider Enumeration Date | 02/02/2023 |
| Last Update Date | 02/09/2023 |
| Medicare PECOS PAC ID | 1254790116 |
|---|---|
| Medicare Enrollment ID | O20230710003580 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497451355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Bryan J Rudiak |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1659426054 PECOS PAC ID: 0749383362 Enrollment ID: I20070319000641 |
| Provider Name | Kimberly Flake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669733838 PECOS PAC ID: 5294991261 Enrollment ID: I20180201000248 |
| Provider Name | Tiffany C Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639714033 PECOS PAC ID: 5193154698 Enrollment ID: I20200404000124 |
| Provider Name | Abigail Jean Magwire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497524912 PECOS PAC ID: 1153767728 Enrollment ID: I20240306002265 |
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