Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 01-05806 | KS |
Y | 111N00000X | Chiropractor | CHR.0007539 | CO |
N | 111NN1001X | Nutrition | 01-05806 | KS |
N | 111NP0017X | Pediatric Chiropractor | CHR.0007539 | CO |
NPI | 1730537127 |
---|---|
Provider Name | Dr. Breanna Ryan |
First Address | Colorado Springs, CO 80922-2603 |
Second Address | Colorado Springs, CO 80922-2603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2016 |
Last Update Date | 29/11/2016 |