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NPI Code Detail

MEDICARE: RYAN FLORENCE DPT

MEDICARE: RYAN FLORENCE DPT
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
1225100000XPhysical Therapist4730NV

General Provider Information

NPI Number : 1083368906
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN FLORENCE DPT
Provider Business Mailing Address
First Line : 9336 RICARDO LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-0144
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2080 E FLAMINGO RD STE 111
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5175
Country : US
Telephone Number : 702-737-8820
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2022
Last Update Date : 02/09/2022

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Directions to “ RYAN FLORENCE DPT” Practice Location

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