Individual
RYAN SCOTT MIZELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6311 DEBARR RD STE J, ANCHORAGE, AK 99504-1777
(336) 755-6446
Mailing address
6311 DEBARR RD STE J, ANCHORAGE, AK 99504-1777
(336) 755-6446
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
126754
AK
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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