Individual
MR. RYAN WILLIAMS LIVESAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1405 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-2171
(573) 335-7868
(573) 335-8193
Mailing address
1405 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-2171
(573) 335-7868
(573) 335-8193
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
204924338
MO
225100000X
Physical Therapist
9191
MO
Other
Enumeration date
04/07/2010
Last updated
04/07/2010
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