Provider Demographics
NPI:1104138528
Name:HEWITT, RYAN JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JAMES
Last Name:HEWITT
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 1:800 TURNPIKE ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-6156
Mailing Address - Country:US
Mailing Address - Phone:978-685-5540
Mailing Address - Fax:978-685-1048
Practice Address - Street 1:800 TURNPIKE ST
Practice Address - Street 2:SUITE 104
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6156
Practice Address - Country:US
Practice Address - Phone:978-685-5540
Practice Address - Fax:978-685-1048
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor