Healthcare Provider Details

I. General information

NPI: 1710604087
Provider Name (Legal Business Name): RYAN LEE BLUMER PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2022
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 E ARMY POST RD
DES MOINES IA
50315-5957
US

IV. Provider business mailing address

1211 E ARMY POST RD
DES MOINES IA
50315-5957
US

V. Phone/Fax

Practice location:
  • Phone: 515-256-9540
  • Fax:
Mailing address:
  • Phone: 515-256-9540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number090295
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: