Provider Demographics
NPI:1447393269
Name:RYCKMAN, WILLIAM DEAN (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DEAN
Last Name:RYCKMAN
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 1:5154 MILLER RD
Mailing Address - Street 2:SUITE J
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1065
Mailing Address - Country:US
Mailing Address - Phone:810-733-0310
Mailing Address - Fax:810-733-5554
Practice Address - Street 1:5154 MILLER RD
Practice Address - Street 2:SUITE J
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1065
Practice Address - Country:US
Practice Address - Phone:810-733-0310
Practice Address - Fax:810-733-5554
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004058111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor