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NPI Code Detail

MEDICARE: RYAN THEILE DPT

MEDICARE: RYAN THEILE DPT
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 Therapist05015396AIN
2225100000XPhysical TherapistPT02088OH

General Provider Information

NPI Number : 1821796335
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN THEILE DPT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 463 OHIO PIKE STE 203
Second Line :
City : CINCINNATI
State : OH
Zip : 45255-3745
Country : US
Telephone Number : 513-247-4340
Fax Number : 513-206-8073
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2023
Last Update Date : 03/05/2026

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