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Individual

MRS. HEATHER L. RYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, ATC, LAT

Contact information

Practice address
1 INDIAN AVE, VENICE, FL 34285-2632
(941) 488-6726
Mailing address
8258 LEOPOLD AVE, NORTH PORT, FL 34287-3745
(941) 423-0952

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 1429
FL

Other

Enumeration date
01/17/2007
Last updated
07/08/2007
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