Individual
RYAN MARK RISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1226 DANTIGNAC ST, AUGUSTA, GA 30901-2788
(706) 922-0600
(706) 922-0604
Mailing address
PO BOX 2344, AUGUSTA, GA 30903-2344
(706) 922-0600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
86270
GA
207Q00000X
Family Medicine Physician
R6885
TX
Other
Enumeration date
05/03/2016
Last updated
07/02/2020
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