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Individual

RYAN CARPENTER VANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
147 PEACHTREE LANE, ADVANCE, NC 27006-6907
(336) 716-2255
(336) 940-2561
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 940-2561

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-01085
NC

Other

Enumeration date
10/16/2007
Last updated
04/20/2010
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