MEDICARE: EMILY M RYAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center	7955	NC
2	225X00000X	Occupational Therapist	7955	NC

General Provider Information

NPI Number	:	1063836161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY M RYAN

Provider Business Mailing Address
First Line	:	2817 ROCK MERRITT AVE
Second Line	:	WOMACK ARMY MEDICAL CENTER
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-8922
Fax Number	:	910-907-6069

Provider Business Practice Location Address
First Line	:	3908 LONG ST BLDG 3-4303
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-7324
Country	:	US
Telephone Number	:	910-907-7777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2014
Last Update Date	:	06/24/2026

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Directions to “ EMILY M RYAN ” Practice Location

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