Provider Demographics
NPI:1912911546
Name:SCHLEISMAN, RYAN DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:DAVID
Last Name:SCHLEISMAN
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 1:4745 BOARDWALK DR UNIT C1
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3769
Mailing Address - Country:US
Mailing Address - Phone:970-207-4066
Mailing Address - Fax:970-225-1392
Practice Address - Street 1:4745 BOARDWALK DR UNIT C1
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3769
Practice Address - Country:US
Practice Address - Phone:970-207-4066
Practice Address - Fax:970-225-1392
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5439111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor