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Individual

RYAN FREDERIC MCNEIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
65 E WADSWORTH PARK DR STE 230, DRAPER, UT 84020-8096
(385) 308-8034
Mailing address
65 E WADSWORTH PARK DR STE 230, DRAPER, UT 84020-8096
(385) 308-8034

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
06615
OR
225100000X
Physical Therapist
Primary
PTL.0012590
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500639158
OR
01
P01197266
RR MEDICARE
WA
Enumeration date
09/14/2011
Last updated
10/14/2022
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