Provider Demographics
NPI:1417526468
Name:PEARSON, RYLAN JOHN DALE (DC)
Entity type:Individual
Prefix:DR
First Name:RYLAN
Middle Name:JOHN DALE
Last Name:PEARSON
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 1:5048 E 57TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-8795
Mailing Address - Country:US
Mailing Address - Phone:605-359-0679
Mailing Address - Fax:
Practice Address - Street 1:5048 E 57TH ST STE A
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8795
Practice Address - Country:US
Practice Address - Phone:605-359-0679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1414111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor