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Individual

MS. JAMIE MARTIN RYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
507 S 4TH ST, GADSDEN, AL 35901
(256) 547-7417
(256) 547-7414
Mailing address
507 S 4TH ST, GADSDEN, AL 35901
(256) 547-7417
(256) 547-7414

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA350
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051518462
AL
01
PA350
STATE MED LIC BD
AL
Enumeration date
07/14/2006
Last updated
10/30/2013
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