Provider Demographics
NPI:1386877991
Name:SMITH, RYAN PHILLIP (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:PHILLIP
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:712 1ST TERR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LANSING
Mailing Address - State:KS
Mailing Address - Zip Code:66043-1704
Mailing Address - Country:US
Mailing Address - Phone:913-250-1200
Mailing Address - Fax:913-250-1201
Practice Address - Street 1:712 1ST TERR
Practice Address - Street 2:SUITE 205
Practice Address - City:LANSING
Practice Address - State:KS
Practice Address - Zip Code:66043-1704
Practice Address - Country:US
Practice Address - Phone:913-220-5900
Practice Address - Fax:913-250-1201
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05281111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor