Provider Demographics
NPI:1861538183
Name:CYPHERS, RONALD LEE (DC)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:LEE
Last Name:CYPHERS
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 1:1144 LEXINGTON AVENUE
Mailing Address - Street 2:ACUTE LOW BACK CLINIC INC
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-2254
Mailing Address - Country:US
Mailing Address - Phone:419-756-0311
Mailing Address - Fax:419-756-0586
Practice Address - Street 1:1144 LEXINGTON AVENUE
Practice Address - Street 2:ACUTE LOW BACK CLINIC INC
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-2254
Practice Address - Country:US
Practice Address - Phone:419-756-0311
Practice Address - Fax:419-756-0586
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH43111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000129042OtherANTHEM BCBS
0004248390OtherAETNA
0394633Medicare ID - Type Unspecified