Provider Demographics
NPI:1699867119
Name:AEBI, RYAN SCOTT (DC, MBA)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:SCOTT
Last Name:AEBI
Suffix:
Gender:M
Credentials:DC, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 W ALLYN AVE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-0892
Mailing Address - Country:US
Mailing Address - Phone:405-714-2460
Mailing Address - Fax:
Practice Address - Street 1:637 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:OK
Practice Address - Zip Code:73077-6635
Practice Address - Country:US
Practice Address - Phone:405-714-2460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3626111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor