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General NPI Number Information
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NPI Number | 1760240485
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Entity Type | Individual
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Provider Name | RYAN E SHOOK D.C., LMT
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Gender | Male
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Dates
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Enumeration Date | 03/07/2024
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 903 WASHINGTON BLVD
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City | BELPRE
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State | OH
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Zip | 45714-2361
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Country | US
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Telephone | 740-262-2957
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Fax |
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Provider Business Mailing Address
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Address Line | 50639 LICKSKILLET RD
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City | REEDSVILLE
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State | OH
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Zip | 45772-9746
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Country | US
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Telephone | 740-262-2957
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 33.022085
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | DC-05107
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License Number State | OH
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