Individual
MR. RYAN T SAYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-4100
Mailing address
PO BOX 829, BLACKFOOT, ID 83221-0829
(208) 523-4906
(208) 523-2025
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-710
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245412063
—
ID
Enumeration date
12/04/2007
Last updated
02/16/2017
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