Individual
MR. MARK ALAN RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
TEACHER/REHAB
Contact information
Practice address
2617 SW 63RD ST, OKLAHOMA CITY, OK 73159-1715
(405) 685-3530
Mailing address
2617 SW 63RD ST, OKLAHOMA CITY, OK 73159-1715
(405) 685-3530
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/19/2010
Last updated
04/19/2010
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