Individual
RYAN SHANE DAMBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1073 WYOMING AVE APT 2, EXETER, PA 18643-1915
(732) 586-0326
Mailing address
732 OCEAN AVENUE APT 33, LONG BRANCH, NJ 07740
(732) 586-0326
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RTO000324
PA
Other
Enumeration date
04/20/2017
Last updated
03/30/2020
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