Individual
MR. RYAN WILLIAM NIEDERKLEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1502 E CENTENNIAL DR, PITTSBURG, KS 66762-6718
(620) 235-0020
Mailing address
1502 E CENTENNIAL DR, PITTSBURG, KS 66762-6718
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1104115
KS
225100000X
Physical Therapist
1157133
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104115
LICENSE NUMBER
KS
01
—
1157133
LICENSE NUMBER
TX
Enumeration date
05/17/2007
Last updated
02/27/2020
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