Provider Demographics
NPI:1376988188
Name:WINCHESTER, RYAN MATHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MATHEW
Last Name:WINCHESTER
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 1:7686 GROUSE AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:IA
Mailing Address - Zip Code:50479-8784
Mailing Address - Country:US
Mailing Address - Phone:641-430-9014
Mailing Address - Fax:
Practice Address - Street 1:820 4TH ST NE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:IA
Practice Address - Zip Code:50441-1424
Practice Address - Country:US
Practice Address - Phone:641-456-2280
Practice Address - Fax:641-456-2280
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007639111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor