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General NPI Number Information
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NPI Number | 1942992516
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Entity Type | Individual
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Provider Name | RYAN KASPRZAK
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Gender | Male
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Dates
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Enumeration Date | 05/23/2023
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 10401 SAWMILL PKWY STE B
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City | POWELL
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State | OH
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Zip | 43065-7451
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Country | US
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Telephone | 380-390-4540
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Fax |
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Provider Business Mailing Address
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Address Line | 5788 DEE DR
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City | HILLIARD
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State | OH
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Zip | 43026-7332
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Country | US
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Telephone | 614-937-4266
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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 | PT020403
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License Number State | OH
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