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General NPI Number Information
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NPI Number | 1053542266
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Entity Type | Organization
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Legal Business Name | RYAN FORD DC LLC
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Dates
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Enumeration Date | 08/05/2009
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Last Update Date | 10/13/2009
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Provider Practice Location Address
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Address Line | 1901 E 32ND ST STE 5
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City | JOPLIN
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State | MO
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Zip | 64804-3071
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Country | US
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Telephone | 417-623-8187
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Fax | 417-623-9011
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Provider Business Mailing Address
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Address Line | 1901 E 32ND ST STE 5
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City | JOPLIN
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State | MO
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Zip | 64804-3071
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Country | US
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Telephone | 417-623-8187
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Fax | 417-623-9011
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Authorized Official
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Title or Position | OWNER
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Name | DR. RYAN S FORD
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Credential | D.C.
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Telephone | 417-623-8187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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