Provider Demographics
NPI:1598789927
Name:RYAN, JEREMY BLAIR (DC)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:BLAIR
Last Name:RYAN
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 1:1945 S OHIO ST STE D
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-6791
Mailing Address - Country:US
Mailing Address - Phone:785-823-7131
Mailing Address - Fax:
Practice Address - Street 1:1945 S OHIO ST STE D
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-6791
Practice Address - Country:US
Practice Address - Phone:785-823-7131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-00719111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor