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Individual

RYAN BUSALACCHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
421 ZANG ST, LAKEWOOD, CO 80228-1052
(303) 996-3844
Mailing address
421 ZANG ST, LAKEWOOD, CO 80228-1052
(928) 853-2836

Taxonomy

Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
0204323
CO

Other

Enumeration date
10/22/2015
Last updated
10/22/2015
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