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General NPI Number Information
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NPI Number | 1174801815
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Entity Type | Organization
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Legal Business Name | RYAN D. MCCAIN, DC, LLC
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Dates
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Enumeration Date | 07/29/2011
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 1278 BRYAN RD
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City | O FALLON
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State | MO
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Zip | 63366-3771
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Country | US
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Telephone | 636-393-8753
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Fax |
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Provider Business Mailing Address
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Address Line | 1278 BRYAN RD
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City | O FALLON
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State | MO
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Zip | 63366-3771
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Country | US
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Telephone | 636-393-8753
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. RYAN DAVID MCCAIN
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Credential | MS, DC
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Telephone | 314-435-0186
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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 | 2010040771
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License Number State | MO
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