Provider Demographics
NPI:1528472297
Name:KUCHAR, MARK (DC)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:KUCHAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 INDIANA ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5027
Mailing Address - Country:US
Mailing Address - Phone:720-536-0580
Mailing Address - Fax:
Practice Address - Street 1:400 INDIANA ST
Practice Address - Street 2:SUITE 320
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5027
Practice Address - Country:US
Practice Address - Phone:720-536-0580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-20
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7081111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor