Individual
MR. RYAN JOSEPH CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
120 S 30TH ST, 2ND FLOOR, PHILADELPHIA, PA 19104-3403
(215) 222-2466
(215) 222-2462
Mailing address
1412 FAIRMOUNT AVENUE, PHILADELPHIA, PA 19130
(215) 599-4851
(215) 232-4093
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA051812
PA
Other
Enumeration date
05/11/2007
Last updated
03/23/2011
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