Provider Demographics
NPI:1518081801
Name:RYAN, CHRISTINE E (LMT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:E
Last Name:RYAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 E UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32641-6038
Mailing Address - Country:US
Mailing Address - Phone:352-318-1000
Mailing Address - Fax:
Practice Address - Street 1:15043 MAIN ST
Practice Address - Street 2:C/O CHIRORPRACTIC ASSOCIATES OF ALACHUA
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-3637
Practice Address - Country:US
Practice Address - Phone:352-318-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL45300225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC3848OtherBCBS PROVIDER NUMBER