Provider Demographics
NPI:1730345711
Name:RYAN CHIROPRACTIC INC.
Entity type:Organization
Organization Name:RYAN CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DARIN
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-589-3427
Mailing Address - Street 1:2701 CALLOWAY DR
Mailing Address - Street 2:402
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2621
Mailing Address - Country:US
Mailing Address - Phone:661-589-3427
Mailing Address - Fax:661-589-4756
Practice Address - Street 1:2701 CALLOWAY DR
Practice Address - Street 2:402
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2621
Practice Address - Country:US
Practice Address - Phone:661-589-3427
Practice Address - Fax:661-589-4756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20771111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0207710Medicare UPIN