MEDICARE: DR. RYAN STEWART ALTER 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	CH 8834	FL

General Provider Information

NPI Number	:	1750332201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN STEWART ALTER D.C.

Provider Business Mailing Address
First Line	:	4205 W ATLANTIC AVE
Second Line	:	102
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3901
Country	:	US
Telephone Number	:	561-819-2225
Fax Number	:	561-819-2228

Provider Business Practice Location Address
First Line	:	4205 W ATLANTIC AVE
Second Line	:	SUITE 102
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445
Country	:	US
Telephone Number	:	561-819-2225
Fax Number	:	561-819-2228

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	01/22/2008

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