Provider Demographics
NPI:1922259605
Name:DANNER, RYAN J (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:J
Last Name:DANNER
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 1:10440 PARK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8504
Mailing Address - Country:US
Mailing Address - Phone:704-453-6339
Mailing Address - Fax:
Practice Address - Street 1:10440 PARK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8504
Practice Address - Country:US
Practice Address - Phone:704-541-7499
Practice Address - Fax:704-541-5565
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3881111N00000X
SC3404111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor