Healthcare Provider Details

I. General information

NPI: 1437804697
Provider Name (Legal Business Name): RYSHAAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 02/16/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3780 RIVERCHASE VLG STE 900
HOOVER AL
35244-1210
US

IV. Provider business mailing address

4210 PAXTON PL
VESTAVIA AL
35242-7468
US

V. Phone/Fax

Practice location:
  • Phone: 205-613-1787
  • Fax:
Mailing address:
  • Phone: 205-613-1787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SIBTAINZEHRA MOMIN
Title or Position: OWNER
Credential:
Phone: 205-613-1787