Provider Demographics
NPI:1093945586
Name:BETZ, RYAN MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MATTHEW
Last Name:BETZ
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 1:4347 INTEGRITY CENTER PT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-1683
Mailing Address - Country:US
Mailing Address - Phone:719-573-1007
Mailing Address - Fax:719-573-1006
Practice Address - Street 1:4347 INTEGRITY CENTER PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-1683
Practice Address - Country:US
Practice Address - Phone:719-573-1007
Practice Address - Fax:719-573-1006
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6561111N00000X, 111N00000X
IL038011522111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor