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Individual

MRS. SUSIE M RYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN M - IV

Contact information

Practice address
1283 LICKING VALLEY RD, NEWARK, OH 43055-8911
(740) 763-0066
Mailing address
1283 LICKING VALLEY RD, NEWARK, OH 43055-8911
(740) 763-0066

Taxonomy

Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
PN066345
OH

Other

Enumeration date
03/15/2011
Last updated
03/16/2011
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