MEDICARE: RYANN P ROBERTS

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	225100000X	Physical Therapist	6813	AZ

General Provider Information

NPI Number	:	1760581557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYANN P ROBERTS

Provider Business Mailing Address
First Line	:	14557 W INDIAN SCHOOL RD
Second Line	:
City	:	GOODYEAR
State	:	AZ
Zip	:	85395-9243
Country	:	US
Telephone Number	:	623-242-6908
Fax Number	:	623-242-6909

Provider Business Practice Location Address
First Line	:	14557 W INDIAN SCHOOL RD
Second Line	:
City	:	GOODYEAR
State	:	AZ
Zip	:	85395-9243
Country	:	US
Telephone Number	:	623-242-6908
Fax Number	:	623-242-6909

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	02/08/2022

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Directions to “ RYANN P ROBERTS ” Practice Location

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