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General NPI Number Information
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NPI Number | 1578233227
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Entity Type | Individual
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Provider Name | RYIAN HUBBARD OTRL
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Gender | Female
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Dates
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Enumeration Date | 09/15/2021
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 601 JOHN ST STE M-206C
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City | KALAMAZOO
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State | MI
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Zip | 49007-5359
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Country | US
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Telephone | 269-349-8601
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Fax |
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Provider Business Mailing Address
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Address Line | 626 MAPLE HILL DR
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City | KALAMAZOO
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State | MI
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Zip | 49009-1032
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Country | US
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Telephone | 692-544-2901
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Fax | 269-544-2901
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201011371
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License Number State | MI
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