MEDICARE: DR. RYAN GRENIER 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
1	111N00000X	Chiropractor	01-05986	KS

General Provider Information

NPI Number	:	1508418914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN GRENIER DC

Provider Business Mailing Address
First Line	:	1122 N SPRING RIDGE CT
Second Line	:
City	:	DERBY
State	:	KS
Zip	:	67037-1300
Country	:	US
Telephone Number	:	316-371-5623
Fax Number	:

Provider Business Practice Location Address
First Line	:	3017 N CYPRESS ST STE B
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-4026
Country	:	US
Telephone Number	:	316-425-1911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2019
Last Update Date	:	05/20/2020

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Directions to “ DR. RYAN GRENIER DC” Practice Location

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