Provider Demographics
NPI:1679859045
Name:MATT RYAN CHIROPRACTIC CORP.
Entity Type:Organization
Organization Name:MATT RYAN CHIROPRACTIC CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-271-7233
Mailing Address - Street 1:3669 HARBOR VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-5006
Mailing Address - Country:US
Mailing Address - Phone:760-271-7233
Mailing Address - Fax:760-434-6150
Practice Address - Street 1:590 LAGUNA DR
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1607
Practice Address - Country:US
Practice Address - Phone:760-434-6141
Practice Address - Fax:760-434-6150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACOR3452261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty