Healthcare Provider Details

I. General information

NPI: 1447393269
Provider Name (Legal Business Name): WILLIAM DEAN RYCKMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 07/08/2007
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 Number2301004058
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: