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General NPI Number Information
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NPI Number | 1629221106
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Entity Type | Individual
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Provider Name | RYAN THOMAS FENTON DPT, MTC, CERTDN,CCI
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Gender | Male
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 24 SARDIS RD SUITE B
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City | ASHEVILLE
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State | NC
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Zip | 28806-9564
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Country | US
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Telephone | 828-785-8388
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Fax | 828-333-4898
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Provider Business Mailing Address
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Address Line | 10 FOREST EDGE DRIVE
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City | ASHEVILLE
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State | NC
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Zip | 28806-9539
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Country | US
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Telephone | 828-785-8388
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Fax | 828-333-4898
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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 | P11798
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 10356
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11798
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License Number State | NC
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