Individual
DR. RYAN EDWARD DERTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
700 BRANCH ST STE 10, PLATTE CITY, MO 64079-9298
(816) 232-5113
Mailing address
62 CRESTWOOD TER, DAVENPORT, IA 52803-3719
(847) 630-7567
(847) 630-7567
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
090090
IA
Other
Enumeration date
03/02/2018
Last updated
03/02/2018
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