Individual
RYAN MOREAU
Active
Individual
RYAN MOREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
2255A2300X
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
SPECIALIST/TECHNOLOGIST - ATHLETIC TRAINER
WA
Enumeration date
10/05/2016
Last updated
10/05/2016
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