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General NPI Number Information
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NPI Number | 1588231625
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Entity Type | Individual
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Provider Name | RYAN DWAYNE HAMNER DPT
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Gender | Male
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 06/08/2021
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Provider Practice Location Address
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Address Line | 150 SHORESIDE DR
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City | LEXINGTON
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State | KY
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Zip | 40515-6433
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Country | US
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Telephone | 859-721-0350
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Fax |
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Provider Business Mailing Address
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Address Line | 744 MOUNT VERNON DR
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City | LEXINGTON
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State | KY
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Zip | 40502-2220
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Country | US
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Telephone | 407-619-5845
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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 | 007273
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License Number State | KY
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