MEDICARE: RYAN THOMAS CHIROPRACTIC PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC011031	PA

General Provider Information

NPI Number	:	1225542814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RYAN THOMAS CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	2130 FREEPORT RD STE 202
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-1542
Country	:	US
Telephone Number	:	724-994-8587
Fax Number	:	724-909-1707

Provider Business Practice Location Address
First Line	:	2130 FREEPORT RD STE 202
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-1542
Country	:	US
Telephone Number	:	724-994-8587
Fax Number	:	724-909-1707

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. RYAN DAVID THOMAS
Credential	:	DC
Telephone Number	:	724-994-8587

Provider Enumeration Date	:	11/20/2017
Last Update Date	:	11/20/2017

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