Provider Demographics
NPI:1902138423
Name:STOFFLE, RYAN (DC)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:STOFFLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 184
Mailing Address - Street 2:
Mailing Address - City:SYLVAN BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:13157-0184
Mailing Address - Country:US
Mailing Address - Phone:315-303-2225
Mailing Address - Fax:
Practice Address - Street 1:200 AKEHURST AVE
Practice Address - Street 2:
Practice Address - City:SYLVAN BEACH
Practice Address - State:NY
Practice Address - Zip Code:13157
Practice Address - Country:US
Practice Address - Phone:315-303-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXO11972111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor