Healthcare Provider Details

I. General information

NPI: 1992623391
Provider Name (Legal Business Name): PEYTON RYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 CORPORATE LN
EXPORT PA
15632-8905
US

IV. Provider business mailing address

619 BUCKINGHAM DR
GREENSBURG PA
15601-6022
US

V. Phone/Fax

Practice location:
  • Phone: 724-832-8272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOC021358
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: