Provider Demographics
NPI:1356345334
Name:WARD, RYAN C (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:C
Last Name:WARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3513 BIRKENHEAD CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-4204
Mailing Address - Country:US
Mailing Address - Phone:859-494-1411
Mailing Address - Fax:859-309-6102
Practice Address - Street 1:108 PASADENA DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2966
Practice Address - Country:US
Practice Address - Phone:859-494-1411
Practice Address - Fax:859-309-6102
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4548111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6101601Medicare ID - Type Unspecified