Individual
RYAN DEANER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 MILITARY ST, PORT HURON, MI 48060-5416
(810) 985-5437
(800) 248-1568
Mailing address
3150 ELECTRIC AVE, PORT HURON, MI 48060-8168
(810) 479-1089
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37260000X
ADULT COMPANION
MI
Enumeration date
06/10/2011
Last updated
06/22/2011
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