Individual
MICHAEL RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3624 RUSSELL BLVD APT A, SAINT LOUIS, MO 63110-3706
(678) 689-7927
Mailing address
3624 RUSSELL BLVD APT A, SAINT LOUIS, MO 63110-3706
(678) 689-7927
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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