Individual
RYAN WILLIAM CLARK
Active
Individual
RYAN WILLIAM CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
67188
WI
208VP0000X
Pain Medicine Physician
67188
WI
208VP0014X
Interventional Pain Medicine Physician
Primary
67188
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100068648
—
WI
Enumeration date
05/13/2014
Last updated
04/21/2026
Update your record
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