Individual
MR. RYAN JOSEPH CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAED, LAT, ATC, OTC
Contact information
Practice address
1201 MICHIGAN AVE STE 140, LOGANSPORT, IN 46947-1530
(574) 722-3338
(574) 753-1551
Mailing address
11500 MAPLE RD, PLYMOUTH, IN 46563-8668
(574) 930-6067
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001087A
IN
Other
Enumeration date
10/31/2006
Last updated
10/27/2022
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