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General NPI Number Information
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NPI Number | 1720992936
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Entity Type | Individual
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Provider Name | SHANE RYAN KOYSTE DPT
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Gender | Male
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Dates
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Enumeration Date | 10/02/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 2211 QUARRY DR STE E55
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City | WEST LAWN
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State | PA
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Zip | 19609-1162
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Country | US
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Telephone | 610-860-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 49 SPRINGHOUSE DR
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City | MYERSTOWN
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State | PA
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Zip | 17067-3110
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Country | US
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Telephone | 484-794-5647
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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 |
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License Number State | NULL
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