Provider Demographics
NPI:1316017239
Name:KEARNS, MICHAEL RYAN (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RYAN
Last Name:KEARNS
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 1:12420 BROOKS CROSSING
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9546
Mailing Address - Country:US
Mailing Address - Phone:317-594-8881
Mailing Address - Fax:
Practice Address - Street 1:2776 E. 146TH ST.
Practice Address - Street 2:
Practice Address - City:CARMEIL
Practice Address - State:IN
Practice Address - Zip Code:46033
Practice Address - Country:US
Practice Address - Phone:317-587-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002305A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor