Individual
TIMOTHY RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
20 CHERRY VALLEY RD, POTTSVILLE, PA 17901-8834
(570) 449-4278
Mailing address
23 CHERRY VALLEY ROAD, POTTSVILLE, PA 17901
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN264828
PA
Other
Enumeration date
03/20/2008
Last updated
03/20/2008
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