Individual
RYAN JACK CHIZMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1404 LAWRENCEVILLE SUWANEE RD STE A1, LAWRENCEVILLE, GA 30043-4331
(954) 257-0104
Mailing address
1404 LAWRENCEVILLE SUWANEE RD STE A1, LAWRENCEVILLE, GA 30043-4331
(954) 257-0104
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
02/21/2024
Last updated
02/21/2024
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