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General NPI Number Information
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NPI Number | 1548454416
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Entity Type | Organization
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Legal Business Name | RYAN S. FORD DC
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 1901 E 32ND ST SUITE 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 SUITE 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 | CHIROPRACTOR
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Name | DR. RYAN S FORD
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Credential | DC
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2003013226
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License Number State | MO
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