Provider Demographics
NPI:1922348994
Name:RILL, ANDREW RYAN (DC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:RYAN
Last Name:RILL
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 1:1833 FOREST DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4492
Mailing Address - Country:US
Mailing Address - Phone:410-216-9180
Mailing Address - Fax:410-216-9669
Practice Address - Street 1:1833 FOREST DR
Practice Address - Street 2:SUITE A
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4492
Practice Address - Country:US
Practice Address - Phone:410-216-9180
Practice Address - Fax:410-216-9669
Is Sole Proprietor?:No
Enumeration Date:2013-02-27
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03737111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor