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NPI Code Detail

MEDICARE: ELAINE RYAN PT

MEDICARE: ELAINE RYAN PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist3179SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00437036OTHERSCRAILROAD MEDICARE NUMBER

General Provider Information

NPI Number : 1417983677
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELAINE RYAN PT
Provider Business Mailing Address
First Line : 8 HOSPITAL CENTER BLVD STE 250
Second Line :
City : HILTON HEAD ISLAND
State : SC
Zip : 29926-8702
Country : US
Telephone Number : 843-671-7342
Fax Number : 843-671-7343
Provider Business Practice Location Address
First Line : 8 HOSPITAL CENTER BLVD STE 250
Second Line :
City : HILTON HEAD ISLAND
State : SC
Zip : 29926-8702
Country : US
Telephone Number : 843-671-7342
Fax Number : 843-671-7343
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 07/21/2022

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