MEDICARE: RYSHAAN LLC

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
1	261QP2000X	Physical Therapy Clinic/Center
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1437804697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RYSHAAN LLC

Provider Business Mailing Address
First Line	:	4210 PAXTON PL
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35242-7468
Country	:	US
Telephone Number	:	205-613-1787
Fax Number	:

Provider Business Practice Location Address
First Line	:	3780 RIVERCHASE VLG STE 900
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-1210
Country	:	US
Telephone Number	:	205-613-1787
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SIBTAINZEHRA MOMIN
Credential	:
Telephone Number	:	205-613-1787

Provider Enumeration Date	:	02/16/2022
Last Update Date	:	02/16/2022

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Directions to “RYSHAAN LLC ” Practice Location

Language	Start Address	Practice Location

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