Provider Demographics
NPI:1093002560
Name:OHL, RYAN DAVID (DC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:DAVID
Last Name:OHL
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 1:5211 S FLETCHER AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-5375
Mailing Address - Country:US
Mailing Address - Phone:904-310-6437
Mailing Address - Fax:904-236-5264
Practice Address - Street 1:5211 S FLETCHER AVE STE 250
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-5375
Practice Address - Country:US
Practice Address - Phone:904-310-6437
Practice Address - Fax:904-263-5264
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH.15516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor