Individual
JENNIFER RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
57 CITY HALL AVE, GARDNER, MA 01440-2614
(978) 630-3862
(978) 630-4176
Mailing address
57 CITY HALL AVE, GARDNER, MA 01440-2614
(978) 630-3862
(978) 630-4176
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
214124
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0178241
—
MA
Enumeration date
02/21/2006
Last updated
11/29/2007
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