Individual
MR. RYAN TOBIAS VAN AMERONGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, ATC, LAT
Contact information
Practice address
875 PERIMETER DR, MS:2302, MOSCOW, ID 83844-2302
(208) 885-0225
Mailing address
307 E E ST, APT: 10, MOSCOW, ID 83843-2661
(208) 885-0225
(208) 885-0254
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/25/2006
Last updated
06/03/2014
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