Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 1522 | OH |
NPI | 1003929688 |
---|---|
Provider Name | Dr. David T Ryan |
First Address | Westerville, OH 43082-8349 |
Second Address | Columbus, OH 43231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 26/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0114629 | (05) | OH |
U27107 | (02) |