Individual
RYAN CHUPAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2601 GRANDVIEW BLVD, WEST LAWN, PA 19609-1324
(610) 670-0180
Mailing address
14 OLD BEDFORD RD, WEST MIDDLESEX, PA 16159-3516
(724) 685-1496
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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