Individual
MR. RYAN RUSSELL MYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
8114 SANDPIPER CIR, SUITE 114, NOTTINGHAM, MD 21236-4934
(410) 933-8459
(410) 933-8712
Mailing address
8114 SANDPIPER CIR, SUITE 114, NOTTINGHAM, MD 21236-4934
(410) 933-8459
(410) 933-8712
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
49721
CA
225200000X
Physical Therapy Assistant
Primary
A4508
MD
Other
Enumeration date
08/15/2016
Last updated
02/12/2019
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