Provider Demographics
NPI:1548454416
Name:RYAN S. FORD DC
Entity type:Organization
Organization Name:RYAN S. FORD DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-623-8187
Mailing Address - Street 1:1901 E 32ND ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-3071
Mailing Address - Country:US
Mailing Address - Phone:417-623-8187
Mailing Address - Fax:417-623-9011
Practice Address - Street 1:1901 E 32ND ST
Practice Address - Street 2:SUITE 5
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3071
Practice Address - Country:US
Practice Address - Phone:417-623-8187
Practice Address - Fax:417-623-9011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003013226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200086OtherBCBS
MO622733OtherHEALTHLINK
KS833957OtherBCBS