Provider Demographics
NPI:1417235839
Name:RYALS, MONTIE FRANK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MONTIE
Middle Name:FRANK
Last Name:RYALS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 DR MARTIN LUTHER KING JUNIOR PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-4422
Mailing Address - Country:US
Mailing Address - Phone:530-342-3776
Mailing Address - Fax:530-332-1746
Practice Address - Street 1:2100 DR MARTIN LUTHER KING JUNIOR PKWY
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-4422
Practice Address - Country:US
Practice Address - Phone:530-342-3776
Practice Address - Fax:530-332-1746
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH37920183500000X
NV14216183500000X
TX38235183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist