Healthcare Provider Details

I. General information

NPI: 1891986568
Provider Name (Legal Business Name): RYKEN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 S ALMA SCHOOL RD STE 5
CHANDLER AZ
85224-7633
US

IV. Provider business mailing address

290 S ALMA SCHOOL RD STE 5
CHANDLER AZ
85224-7633
US

V. Phone/Fax

Practice location:
  • Phone: 480-857-1991
  • Fax: 480-857-2036
Mailing address:
  • Phone: 480-857-1991
  • Fax: 480-857-2036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7728
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4418
License Number StateAZ

VIII. Authorized Official

Name: DR. RYAN EDWARD HICKS
Title or Position: DR OF CHIROPRACTIC/OWNER
Credential: D.C.
Phone: 480-857-1991