Provider Demographics
NPI:1992236061
Name:RYCKMAN CHIROPRACTIC CLINIC PC
Entity type:Organization
Organization Name:RYCKMAN CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-770-4930
Mailing Address - Street 1:5154 MILLER RD
Mailing Address - Street 2:STE J
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1065
Mailing Address - Country:US
Mailing Address - Phone:810-710-0310
Mailing Address - Fax:
Practice Address - Street 1:5154 MILLER RD
Practice Address - Street 2:STE J
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1065
Practice Address - Country:US
Practice Address - Phone:810-710-0310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty