Individual
MR. RYAN ROBERT CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD, OTR/L
Contact information
Practice address
1309 SOUTHMORELAND PL, SHENANDOAH, IA 51601-2247
(712) 246-8179
Mailing address
823 S 17TH ST, P.O. BOX 217, CLARINDA, IA 51632-2625
(712) 246-8224
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01630
IA
Other
Enumeration date
12/18/2008
Last updated
12/18/2008
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