Organization
RYAN AVERETT DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN KENNETH AVERETT D.P.M. (PRESIDENT)
(208) 661-0295
Entity
Organization
Contact information
Practice address
2221 W IRONWOOD CENTER DR, COEUR D ALENE, ID 83814-2697
(208) 667-3585
(855) 864-8364
Mailing address
1118 N 4TH ST, COEUR D ALENE, ID 83814-3217
(208) 667-3585
(208) 666-9214
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
P177
ID
Other
Enumeration date
06/08/2006
Last updated
07/21/2022
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