MEDICARE: DR. RYAN DANIEL SMITH 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	3422	OH

General Provider Information

NPI Number	:	1922062678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN DANIEL SMITH D.C.

Provider Business Mailing Address
First Line	:	175 SEATRAIN DR
Second Line	:
City	:	DELAWARE
State	:	OH
Zip	:	43015-3407
Country	:	US
Telephone Number	:	740-972-9265
Fax Number	:

Provider Business Practice Location Address
First Line	:	4250 N HIGH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-3048
Country	:	US
Telephone Number	:	614-586-0024
Fax Number	:	614-586-0401

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	11/25/2014

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