Provider Demographics
NPI:1437540895
Name:MOELLER, RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:MOELLER
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 1:1912 COLUMBIA AVE
Mailing Address - Street 2:STE A
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3950
Mailing Address - Country:US
Mailing Address - Phone:615-614-3772
Mailing Address - Fax:
Practice Address - Street 1:1912 COLUMBIA AVE
Practice Address - Street 2:STE A
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3950
Practice Address - Country:US
Practice Address - Phone:615-614-3772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000002817111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor