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General NPI Number Information
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NPI Number | 1790019552
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Entity Type | Individual
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Provider Name | RYAN TODD HUGHES DPT
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Gender | Male
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Dates
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Enumeration Date | 09/28/2009
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 5836 RICHARD ST
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City | JACKSONVILLE
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State | FL
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Zip | 32216-5925
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Country | US
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Telephone | 904-306-9729
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Fax |
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Provider Business Mailing Address
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Address Line | 4854 BOAT LANDING DR
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32092-3693
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Country | US
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Telephone | 330-354-1394
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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 | PT25007
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License Number State | FL
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