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Individual

RYAN GERAGHTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MAT, ATC, LAT

Contact information

Practice address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(574) 261-7517
Mailing address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(574) 261-7517

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002260A
IN

Other

Enumeration date
10/14/2014
Last updated
12/04/2024
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