MEDICARE: SAYGE RYAN CTRS

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	225800000X	Recreation Therapist	87569	IN

General Provider Information

NPI Number	:	1588491476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAYGE RYAN CTRS

Provider Business Mailing Address
First Line	:	6728 DEL RIO DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46835-1711
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6728 DEL RIO DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46835-1711
Country	:	US
Telephone Number	:	260-494-2376
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	09/16/2024

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Directions to “ SAYGE RYAN CTRS” Practice Location

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