Provider Demographics
NPI:1891026175
Name:DR. RYAN J. NELSON P.C.
Entity Type:Organization
Organization Name:DR. RYAN J. NELSON P.C.
Other - Org Name:VERNAL CHIROPRACTIC CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:435-789-4483
Mailing Address - Street 1:285 E 100 S
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2636
Mailing Address - Country:US
Mailing Address - Phone:435-789-4483
Mailing Address - Fax:435-789-4488
Practice Address - Street 1:285 E 100 S
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2636
Practice Address - Country:US
Practice Address - Phone:435-789-4483
Practice Address - Fax:435-789-4488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty