Individual
MR. RYAN PEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
4714 S COLONIAL OAKS DR, MARION, IN 46953-7308
(765) 674-2261
Mailing address
3650 MEADOW VIEW DR, KOKOMO, IN 46902-5070
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004681A
IN
Other
Enumeration date
04/18/2011
Last updated
04/18/2011
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