Healthcare Provider Details

I. General information

NPI: 1487285045
Provider Name (Legal Business Name): RYAN CRAIG GUTZ DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 1ST AVE S
CONOVER NC
28613-2704
US

IV. Provider business mailing address

509 OLIVE WAY STE 620
SEATTLE WA
98101-1761
US

V. Phone/Fax

Practice location:
  • Phone: 828-464-7791
  • Fax: 828-465-4062
Mailing address:
  • Phone: 206-622-9001
  • Fax: 206-622-4311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH61205025
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: