Healthcare Provider Details

I. General information

NPI: 1003095456
Provider Name (Legal Business Name): RYCKMAN CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5154 MILLER RD SUITE J
FLINT MI
48507-1065
US

IV. Provider business mailing address

5154 MILLER RD SUITE J
FLINT MI
48507-1065
US

V. Phone/Fax

Practice location:
  • Phone: 810-733-0310
  • Fax: 810-733-5554
Mailing address:
  • Phone: 810-733-0310
  • Fax: 810-733-5554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM DEAN RYCKMAN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 810-733-0310