Provider Demographics
NPI:1932978814
Name:RYAN HEROLD P.C.
Entity Type:Organization
Organization Name:RYAN HEROLD P.C.
Other - Org Name:PEAK PERFORMANCE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEROLD
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MS
Authorized Official - Phone:406-222-4444
Mailing Address - Street 1:1201 US HIGHWAY 10 W STE C
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-9022
Mailing Address - Country:US
Mailing Address - Phone:406-222-4444
Mailing Address - Fax:406-222-9796
Practice Address - Street 1:1201 US HIGHWAY 10 W STE C
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-9022
Practice Address - Country:US
Practice Address - Phone:406-222-4444
Practice Address - Fax:406-222-9796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty