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Individual

DONAVAN MARQUE RYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
11551 EDISON ST NE, ALLIANCE, OH 44601-9613
(330) 581-9730
Mailing address
11551 EDISON ST NE, ALLIANCE, OH 44601-9613
(330) 581-9730

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
155170
OH

Other

Enumeration date
09/14/2015
Last updated
01/28/2016
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