Healthcare Provider Details

I. General information

NPI: 1881774792
Provider Name (Legal Business Name): PATRICK TRENT RYAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 04/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 SHARPLEY RD
WILMINGTON DE
19803-2941
US

IV. Provider business mailing address

6 SHARPLEY RD
WILMINGTON DE
19803-2941
US

V. Phone/Fax

Practice location:
  • Phone: 302-778-0100
  • Fax: 302-652-1116
Mailing address:
  • Phone: 302-778-0100
  • Fax: 302-652-1116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberF1-0000443
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: