Provider Demographics
NPI:1063207173
Name:DENOME, RYAN (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:DENOME
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5382 COX SMITH RD STE A
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6803
Mailing Address - Country:US
Mailing Address - Phone:513-208-7498
Mailing Address - Fax:
Practice Address - Street 1:5382 COX SMITH RD STE A
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6803
Practice Address - Country:US
Practice Address - Phone:513-208-7498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor