Provider Demographics
NPI:1396158184
Name:EYRING, RORY DIRK (ATC)
Entity type:Individual
Prefix:
First Name:RORY
Middle Name:DIRK
Last Name:EYRING
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:FORT SCOTT
Mailing Address - State:KS
Mailing Address - Zip Code:66701-2986
Mailing Address - Country:US
Mailing Address - Phone:620-223-2700
Mailing Address - Fax:620-223-4438
Practice Address - Street 1:2108 HORTON ST
Practice Address - Street 2:
Practice Address - City:FORT SCOTT
Practice Address - State:KS
Practice Address - Zip Code:66701-3141
Practice Address - Country:US
Practice Address - Phone:620-223-2700
Practice Address - Fax:620-223-4438
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-008102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer