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Individual
MR. RYAN ELLSWORTH FARR
Active
Individual
MR. RYAN ELLSWORTH FARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
3958
OR
225100000X
Physical Therapist
Primary
PT26976
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT269760
BLUE SHIELD
CA
01
—
4563670001
DMERC
CA
05
—
PT0269760
—
CA
Enumeration date
06/07/2006
Last updated
07/08/2007
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