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General NPI Number Information
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NPI Number | 1700511540
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Entity Type | Individual
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Provider Name | RYAN WILLIAM JAMES OTR/L
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Gender | Male
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Dates
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Enumeration Date | 07/17/2022
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Last Update Date | 07/17/2022
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Provider Practice Location Address
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Address Line | 817 CRAWFORD AVE
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City | AUGUSTA
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State | GA
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Zip | 30904-3772
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Country | US
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Telephone | 706-736-1255
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Fax |
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Provider Business Mailing Address
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Address Line | 4368 DEERWOOD LN
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City | EVANS
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State | GA
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Zip | 30809-4604
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Country | US
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Telephone | 706-305-8292
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT008522
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License Number State | GA
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