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General NPI Number Information
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NPI Number | 1114259801
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Entity Type | Individual
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Provider Name | RYAN M CAVANAUGH DPT
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Gender | Male
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 254 CONVENTION CENTER DR
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City | DUNCANSVILLE
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State | PA
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Zip | 16635-8244
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Country | US
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Telephone | 814-788-2553
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Fax | 814-788-2553
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Provider Business Mailing Address
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Address Line | 4750 LINDLE RD STE 100
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City | HARRISBURG
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State | PA
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Zip | 17111-2428
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Country | US
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Telephone | 717-803-3342
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Fax | 717-974-8743
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT020399
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License Number State | PA
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