Healthcare Provider Details

I. General information

NPI: 1346129814
Provider Name (Legal Business Name): RYAN YOUTA CRABTREE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: YOUTA NAKA DC

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2-17-20 MINAMITOBARU
OKINAWA-CITY OKINAWA
9040035
JP

IV. Provider business mailing address

2-17-20 MINAMITOBARU
OKINAWA-CITY OKINAWA
9040035
JP

V. Phone/Fax

Practice location:
  • Phone: 316-315-9325
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0008951
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: