Provider Demographics
NPI:1275647927
Name:KNOWLES, RYAN M (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:M
Last Name:KNOWLES
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 1:2834 ACUSHNET AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-3412
Mailing Address - Country:US
Mailing Address - Phone:508-998-3001
Mailing Address - Fax:508-998-1461
Practice Address - Street 1:2834 ACUSHNET AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-3412
Practice Address - Country:US
Practice Address - Phone:508-998-3001
Practice Address - Fax:508-998-1461
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
4400529OtherUNITED HEALTH CARE
2161664OtherAETNA
MA797199OtherTUFTS
MA1612379Medicaid
351207OtherHAVARD PILGRIM HEALTHCARE
043472756OtherHEALTH CARE VALUE MANAGEM
B20823201OtherCIGNA
MAY36553OtherBCBS
000000022591OtherBOSTON MEDICAL HEALTH NET
MAY39254OtherBCBS
2161664OtherAETNA
B20823201OtherCIGNA