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General NPI Number Information
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NPI Number | 1174851109
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Entity Type | Individual
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Provider Name | PATRICIA ANNE RYAN P.T.
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Gender | Female
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Dates
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Enumeration Date | 12/02/2009
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Last Update Date | 12/02/2009
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Provider Practice Location Address
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Address Line | 1 EVERGREEN DR
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-1506
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Country | US
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Telephone | 401-228-1120
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3214
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City | NEWPORT
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State | RI
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Zip | 02840-0323
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Country | US
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Telephone | 401-662-6114
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT01609
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License Number State | RI
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