Provider Demographics
NPI:1033446182
Name:RYAN BETZ, D.C., P.C.
Entity Type:Organization
Organization Name:RYAN BETZ, D.C., P.C.
Other - Org Name:EXODUS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:BETZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-927-8662
Mailing Address - Street 1:1020 104TH STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564
Mailing Address - Country:US
Mailing Address - Phone:630-718-0554
Mailing Address - Fax:630-718-0555
Practice Address - Street 1:1020 104TH STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564
Practice Address - Country:US
Practice Address - Phone:630-718-0554
Practice Address - Fax:630-718-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011522385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care