Individual
RYAN SIMONSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7 MILES WEST OF PINON, PINON, AZ 86510-0358
(928) 890-9310
Mailing address
PO BOX 358, PINON, AZ 86510-0358
(928) 890-9310
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
310400000X
Assisted Living Facility
—
—
Other
Enumeration date
04/26/2021
Last updated
09/25/2022
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