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General NPI Number Information
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NPI Number | 1174732507
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Entity Type | Individual
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Provider Name | RYAN LOUIS ZINK MS, ATC, LAT
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1160 N PEACHTREE-ROOM # 114
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City | COOKEVILLE
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State | TN
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Zip | 38505-0001
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Country | US
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Telephone | 931-372-3968
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Fax |
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Provider Business Mailing Address
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Address Line | 70 E 18TH ST APT D
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City | COOKEVILLE
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State | TN
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Zip | 38501-4893
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Country | US
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Telephone | 620-617-4146
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT 0000001084
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License Number State | TN
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