Gustafson, Ryan Dennis
Gustafson, Ryan Dennis is an sole proprietor health care provider with primary practice located at 1910 Lucille Ave Suite 1, Kingman AZ 86401-4693. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Gustafson, Ryan Dennis can be contacted via phone (928) 753-2047.Contact Information
Primary practice address
1910 Lucille Ave Suite 1
Kingman AZ 86401-4693
Phone: (928) 753-2047
Fax: (928) 753-2020
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 7156 | Arizona |
Profile Details
| NPI number | 1407938798 |
|---|---|
| LBN Legal business name | Gustafson, Ryan Dennis |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407938798 | NPPES |
| Arizona | Other | 3142303 | AETNA |
| Arizona | Other | AZ0937240 | AETNA |
| Arizona | Other | 1212439 | AETNA |
| Arizona | Other | 1Z5906 | AETNA |
| Arizona | Other | 5291063 | AETNA |
| Arizona | MEDICAID | 692659 | AETNA |
| Arizona | Other | 229944 | AETNA |
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