Provider Demographics
NPI:1548495567
Name:HALLMARK, RYAN JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JAMES
Last Name:HALLMARK
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 1:1924 OAK PARK BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4647
Mailing Address - Country:US
Mailing Address - Phone:925-350-1667
Mailing Address - Fax:
Practice Address - Street 1:1924 OAK PARK BLVD STE B
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4647
Practice Address - Country:US
Practice Address - Phone:925-350-1667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25449111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA25449OtherSTATE BOARD