Provider Demographics
NPI:1619284874
Name:BECK, RYAN DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:DAVID
Last Name:BECK
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 1:57 E 800 N
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-1210
Mailing Address - Country:US
Mailing Address - Phone:801-798-7176
Mailing Address - Fax:801-798-7375
Practice Address - Street 1:57 E 800 N
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1210
Practice Address - Country:US
Practice Address - Phone:801-798-7176
Practice Address - Fax:801-798-7375
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT84069371202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor