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Individual

RYAN WOCKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, LAT, ATC, CES

Contact information

Practice address
3200 S WATER ST, PITTSBURGH, PA 15203
(412) 365-2946
Mailing address
0 WOODLAND RD, PITTSBURGH, PA 15232-2899
(412) 365-2946

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT005910
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000017970
BOARD OF CERTIFICATION
01
RT005910
COMMONWEALTH OF PENNSYLVANIA ATHLETIC TRAINERS LICENSE
PA
Enumeration date
12/05/2014
Last updated
04/09/2019
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