Individual
DELTA RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
(863) 687-1132
(863) 687-1439
Mailing address
5426 CHARLIN AVE, LAKELAND, FL 33810-8236
(863) 859-5611
(727) 507-3618
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2714
FL
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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