Provider Demographics
NPI:1174921464
Name:KLEE, RYAN (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:KLEE
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 1:4104 W LINEBAUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-5239
Mailing Address - Country:US
Mailing Address - Phone:813-229-2225
Mailing Address - Fax:813-221-2225
Practice Address - Street 1:4104 W LINEBAUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-5239
Practice Address - Country:US
Practice Address - Phone:813-229-2225
Practice Address - Fax:813-221-2225
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 11362111N00000X
NYX012539111N00000X
DEF1-0000912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor