Provider Demographics
NPI:1043566722
Name:HORKAN, CHAD
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
Last Name:HORKAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 GLACIER DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-1074
Mailing Address - Country:US
Mailing Address - Phone:970-985-8755
Mailing Address - Fax:
Practice Address - Street 1:681 HORIZON DR
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1995
Practice Address - Country:US
Practice Address - Phone:970-257-1392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist