Individual
RYAN WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2959
(218) 703-1227
Mailing address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2959
(218) 703-1227
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010423A
IN
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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