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General NPI Number Information
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NPI Number | 1134471600
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Entity Type | Organization
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Legal Business Name | RYAN CHIROPRACTIC CLINIC PA
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Dates
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Enumeration Date | 10/09/2012
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 1945 S OHIO ST
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City | SALINA
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State | KS
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Zip | 67401-6791
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Country | US
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Telephone | 785-823-7131
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Fax |
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Provider Business Mailing Address
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Address Line | 1945 S OHIO ST
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City | SALINA
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State | KS
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Zip | 67401-6791
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Country | US
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Telephone | 785-823-7131
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEREMY BLAIR RYAN
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Credential | D.C.
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Telephone | 785-823-7131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5052
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License Number State | KS
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