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General NPI Number Information
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NPI Number | 1518858992
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Entity Type | Individual
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Provider Name | RYAN RYSKAMP PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 1625 E MAIN ST STE 101&104
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City | EL CAJON
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State | CA
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Zip | 92021-5211
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Country | US
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Telephone | 619-873-2160
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Fax |
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Provider Business Mailing Address
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Address Line | 13732 PASEO VALLE ALTO
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City | POWAY
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State | CA
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Zip | 92064-2165
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Country | US
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Telephone | 858-775-1631
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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 | PT308114
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License Number State | CA
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