Individual
RYAN T VANROO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2505 MILTON AVE, JANESVILLE, WI 53545-0441
(608) 756-5225
Mailing address
2505 MILTON AVE, JANESVILLE, WI 53545-0441
(608) 756-5225
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3734-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38929900
—
WI
01
—
38994700
MEDICAID GROUP
WI
Enumeration date
09/24/2006
Last updated
02/09/2016
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