Individual
KATHRYN CLAIRE RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
266 SH 150, NEW WAVERLY, TX 77358
(651) 398-0254
Mailing address
266 SH 150, NEW WAVERLY, TX 77358
(651) 398-0254
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT6194
TX
Other
Enumeration date
05/10/2017
Last updated
05/10/2017
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