Individual
JEREMY RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
203 SPARKS AVE, JEFFERSONVILLE, IN 47130-3732
(812) 590-8217
Mailing address
3228 HARMONY LN, CHARLESTOWN, IN 47111-8664
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005561A
IN
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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