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General NPI Number Information
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NPI Number | 1689960312
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Entity Type | Individual
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Provider Name | RYAN GABRIEL BROYLES AU.D., CCC-A
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Gender | Male
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Dates
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Enumeration Date | 06/21/2011
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 105 S MAIN ST
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City | FRANKLIN
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State | KY
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Zip | 42134-2113
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Country | US
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Telephone | 270-776-9905
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Fax |
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Provider Business Mailing Address
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Address Line | 105 S MAIN ST
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City | FRANKLIN
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State | KY
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Zip | 42134-2113
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Country | US
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Telephone | 270-776-9905
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1921
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 168581
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 167959
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License Number State | KY
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