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General NPI Number Information
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NPI Number | 1760716690
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Entity Type | Individual
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Provider Name | RYAN JAMES CHRISTIANSEN P.T.
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Gender | Male
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Dates
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Enumeration Date | 09/24/2009
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Last Update Date | 09/24/2009
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Provider Practice Location Address
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Address Line | 540 E PALM AVE APT. M
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City | BURBANK
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State | CA
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Zip | 91501-2067
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Country | US
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Telephone | 818-321-3164
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Fax |
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Provider Business Mailing Address
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Address Line | 540 EAST PALM AVE. APT. M
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City | BURBANK
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State | CA
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Zip | 91501
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Country | US
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Telephone | 818-321-3164
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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 | PT 25258
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License Number State | CA
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