Provider Demographics
NPI:1437685302
Name:RYCAHAN INC
Entity type:Organization
Organization Name:RYCAHAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERGREN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:2254-675-3078
Mailing Address - Street 1:230 N AVENUE D
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:TX
Mailing Address - Zip Code:76634-1620
Mailing Address - Country:US
Mailing Address - Phone:254-675-3078
Mailing Address - Fax:254-675-3145
Practice Address - Street 1:230 N AVENUE D
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TX
Practice Address - Zip Code:76634-1620
Practice Address - Country:US
Practice Address - Phone:254-675-3078
Practice Address - Fax:254-675-3145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty