MEDICARE: DR. RYAN S FORD D.C.

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	2003013226	MO
2	111N00000X	Chiropractor	4384	SC

General Provider Information

NPI Number	:	1558344754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN S FORD D.C.

Provider Business Mailing Address
First Line	:	5394 JUG FACTORY RD
Second Line	:
City	:	CAMPOBELLO
State	:	SC
Zip	:	29322-9627
Country	:	US
Telephone Number	:	864-256-7968
Fax Number	:

Provider Business Practice Location Address
First Line	:	552 MEMORIAL DRIVE EXT # 205
Second Line	:
City	:	GREER
State	:	SC
Zip	:	29651-1135
Country	:	US
Telephone Number	:	864-256-7968
Fax Number	:

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	10/29/2024

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