Provider Demographics
NPI:1689422743
Name:CHIEN, TIMOTHY RYDER (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:RYDER
Last Name:CHIEN
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6340 PUMPKIN RIDGE DR UNIT 2
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-7133
Mailing Address - Country:US
Mailing Address - Phone:518-524-5034
Mailing Address - Fax:
Practice Address - Street 1:6340 PUMPKIN RIDGE DR UNIT 2
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-7133
Practice Address - Country:US
Practice Address - Phone:518-524-5034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0024935225700000X
NY016309225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist