Healthcare Provider Details

I. General information

NPI: 1720386386
Provider Name (Legal Business Name): SEAN PATRICK RYAN ASRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2011
Last Update Date: 03/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1470 E CALVADA BLVD STE. 100
PAHRUMP NV
89048-3905
US

IV. Provider business mailing address

1655 W HORIZON RIDGE PKWY STE. 100
HENDERSON NV
89012-3494
US

V. Phone/Fax

Practice location:
  • Phone: 775-537-2300
  • Fax: 775-537-2345
Mailing address:
  • Phone: 702-914-2790
  • Fax: 702-914-5984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberRC1879
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: