Healthcare Provider Details

I. General information

NPI: 1376473306
Provider Name (Legal Business Name): RYAN PATRICK DEVLIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 E MAUMEE ST STE 3
ADRIAN MI
49221-2735
US

IV. Provider business mailing address

3632 WILLOWNICOLE LN
ADRIAN MI
49221-1066
US

V. Phone/Fax

Practice location:
  • Phone: 517-263-5810
  • Fax:
Mailing address:
  • Phone: 517-902-5758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6451025078
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: