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NPI Code Detail

MEDICARE: RYAN ENZWEILER

MEDICARE: RYAN ENZWEILER
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
12255A2300XAthletic TrainerAT1309OH

General Provider Information

NPI Number : 1285098434
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN ENZWEILER
Provider Business Mailing Address
First Line : 424 MILLRACE DR
Second Line :
City : COLD SPRING
State : KY
Zip : 41076-2190
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 463 OHIO PIKE STE 203
Second Line :
City : CINCINNATI
State : OH
Zip : 45255-3745
Country : US
Telephone Number : 513-247-4340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2016
Last Update Date : 04/13/2016

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Directions to “ RYAN ENZWEILER ” Practice Location

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