Provider Demographics
NPI:1871672394
Name:KISH, RYAN SEITZ (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:SEITZ
Last Name:KISH
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 1:8110 SANTALO COVE CT
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-5026
Mailing Address - Country:US
Mailing Address - Phone:203-470-2770
Mailing Address - Fax:
Practice Address - Street 1:11211 PROSPERITY FARMS RD STE 204
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3467
Practice Address - Country:US
Practice Address - Phone:203-470-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001697111N00000X
FLCH13481111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor