Provider Demographics
NPI:1750332201
Name:ALTER, RYAN STEWART (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:STEWART
Last Name:ALTER
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 1:4205 W ATLANTIC AVE
Mailing Address - Street 2:102
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3901
Mailing Address - Country:US
Mailing Address - Phone:561-819-2225
Mailing Address - Fax:561-819-2228
Practice Address - Street 1:4205 W ATLANTIC AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445
Practice Address - Country:US
Practice Address - Phone:561-819-2225
Practice Address - Fax:561-819-2228
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8834111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV09577Medicare UPIN
FLU7630ZMedicare PIN