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NPI Code Detail

MEDICARE: RYAN SOUSLEY DC

MEDICARE: RYAN SOUSLEY DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCHIA1447ID

General Provider Information

NPI Number : 1144507575
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN SOUSLEY DC
Provider Business Mailing Address
First Line : 3693 S PUMA DR
Second Line :
City : COEUR D ALENE
State : ID
Zip : 83814-9011
Country : US
Telephone Number : 208-771-4474
Fax Number :
Provider Business Practice Location Address
First Line : 2634 N GOVERNMENT WAY
Second Line :
City : COEUR D ALENE
State : ID
Zip : 83815-3750
Country : US
Telephone Number : 208-771-4474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2011
Last Update Date : 01/28/2026

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Directions to “ RYAN SOUSLEY DC” Practice Location

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