Provider Demographics
NPI:1912239302
Name:BARKER, RYAN D
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:D
Last Name:BARKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 W ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2410
Mailing Address - Country:US
Mailing Address - Phone:315-326-0440
Mailing Address - Fax:315-291-8062
Practice Address - Street 1:113 W ALBANY ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2410
Practice Address - Country:US
Practice Address - Phone:315-326-0440
Practice Address - Fax:315-291-8062
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011970111NN1001X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition