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General NPI Number Information
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NPI Number | 1134704208
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Entity Type | Organization
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Legal Business Name | DR RYAN SHINE LLC
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 298 OLD US HWY 30
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City | GREENSBURG
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State | PA
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Zip | 15601
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Country | US
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Telephone | 724-834-0389
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Fax |
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Provider Business Mailing Address
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Address Line | 298 OLD ROUTE 30
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City | GREENSBURG
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State | PA
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Zip | 15601-7035
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Country | US
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Telephone | 724-875-0559
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Fax | 724-834-0390
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CASSY JEAN RAGAZZINI
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Credential |
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Telephone | 724-834-0389
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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 |
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License Number State |
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