Church, Ryder Michael

Church, Ryder Michael is an sole proprietor health care provider with primary practice located at 901 W Glen Ave Suite A, Peoria IL 61614-4836. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Church, Ryder Michael can be contacted via phone (309) 693-1212.

Contact Information

Primary practice address
901 W Glen Ave Suite A Peoria IL 61614-4836
Fax: (309) 693-2147
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 038007166 Illinois

Profile Details

NPI number 1104898659
LBN Legal business name Church, Ryder Michael
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 7th, 2006
Last updated Jan 30th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104898659 NPPES
Illinois MEDICAID 038007166

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