Individual
MR. RYAN MICHAEL DEWOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
541 SOUTH COLLEGE AVE, NEWARK, DE 19711
(978) 302-1857
Mailing address
541 SOUTH COLLEGE AVE, NEWARK, DE 19711
(978) 302-1857
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
J3-0000573
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J3-0000573
EXAMINING BOARD OF PHYSICAL THERAPIST AND ATHLETIC TRAINERS
DE
Enumeration date
12/08/2016
Last updated
12/08/2016
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