Provider Demographics
NPI:1306966650
Name:HOLMES, RYAN HAROLD (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:HAROLD
Last Name:HOLMES
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 1:3007 N BELT HWY STE I
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-1557
Mailing Address - Country:US
Mailing Address - Phone:816-232-8377
Mailing Address - Fax:816-279-0302
Practice Address - Street 1:3007 N BELT HWY STE I
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-1557
Practice Address - Country:US
Practice Address - Phone:816-232-8377
Practice Address - Fax:816-279-0302
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004008727111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOS230000Medicare ID - Type Unspecified