Individual
MS. MAXIENE H RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
301 ANDREWS AVENUE, FORT RUCKER, AL 36362
(334) 255-7894
Mailing address
170 HWY 134 EAST, DALEVILLE, AL 36322
(334) 598-4892
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-019139
AL
Other
Enumeration date
02/05/2008
Last updated
02/05/2008
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