Provider Demographics
NPI:1891889630
Name:RYAN, MARGARET ELIZABETH (DC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:RYAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 W BANNOCK ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5999
Mailing Address - Country:US
Mailing Address - Phone:208-429-9355
Mailing Address - Fax:
Practice Address - Street 1:950 W BANNOCK ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5999
Practice Address - Country:US
Practice Address - Phone:208-429-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA1200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor