Individual
RYAN TIMOTHY BLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282
(269) 337-4400
Mailing address
100 THEDA CLARK MEDICAL PLZ, STE 400, NEENAH, WI 54956-2763
(920) 725-4527
(920) 729-2378
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
69044
WI
Other
Enumeration date
05/03/2013
Last updated
07/13/2018
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