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Individual
RYAN AVELLANOSA
Active
Individual
RYAN AVELLANOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
070.020390
IL
225100000X
Physical Therapist
Primary
070020390
IL
Other
Enumeration date
06/21/2016
Last updated
03/07/2023
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