Healthcare Provider Details

I. General information

NPI: 1669399150
Provider Name (Legal Business Name): RYAN CALLAHAN A.P., L.M.T
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2234 NW 40TH TER
GAINESVILLE FL
32605-3590
US

IV. Provider business mailing address

2234 NW 40TH TER
GAINESVILLE FL
32605-3590
US

V. Phone/Fax

Practice location:
  • Phone: 352-234-6366
  • Fax:
Mailing address:
  • Phone: 352-234-6366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number4765
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: