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Individual
RYAN WOCKLEY
Active
Individual
RYAN WOCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC, CES
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT005910
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000017970
BOARD OF CERTIFICATION
—
01
—
RT005910
COMMONWEALTH OF PENNSYLVANIA ATHLETIC TRAINERS LICENSE
PA
Enumeration date
12/05/2014
Last updated
04/09/2019
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