Provider Demographics
NPI:1548222029
Name:HILES, RYAN LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:LEE
Last Name:HILES
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 1:1041 MORRELL AVE
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-3958
Mailing Address - Country:US
Mailing Address - Phone:724-628-6699
Mailing Address - Fax:724-628-3830
Practice Address - Street 1:1041 MORRELL AVE
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-3958
Practice Address - Country:US
Practice Address - Phone:724-628-6699
Practice Address - Fax:724-628-3830
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009569111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor