1497037964 NPI number — MR. RYAN ALAN YANEZ D.C.

Table of content: MR. RYAN ALAN YANEZ D.C. (NPI 1497037964)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497037964 NPI number — MR. RYAN ALAN YANEZ D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YANEZ
Provider First Name:
RYAN
Provider Middle Name:
ALAN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497037964
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6780 ROCHESTER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TROY
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48085-1283
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-879-8144
Provider Business Mailing Address Fax Number:
248-879-8144

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
42950 SCHOENHERR
Provider Second Line Business Practice Location Address:
BI COUNTY CHIROPRACTIC
Provider Business Practice Location Address City Name:
STERLING HEIGHTS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48313-2852
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-247-0100
Provider Business Practice Location Address Fax Number:
586-247-1350
Provider Enumeration Date:
09/12/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2301009848 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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