Provider Demographics
NPI:1740055961
Name:KERNER, RYAN ALFRED (DC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:ALFRED
Last Name:KERNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CRINGLE LN
Mailing Address - Street 2:
Mailing Address - City:MORRISONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12962-2803
Mailing Address - Country:US
Mailing Address - Phone:518-569-8321
Mailing Address - Fax:
Practice Address - Street 1:43 DURKEE ST STE 600C
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2953
Practice Address - Country:US
Practice Address - Phone:518-324-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPENDINGGRADUATION111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor