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NPI Code Detail

MEDICARE: RYAN DAVID PARKER

MEDICARE: RYAN DAVID PARKER
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 TherapistP24582NC
2225100000XPhysical Therapist054917NY

General Provider Information

NPI Number : 1407719735
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN DAVID PARKER
Provider Business Mailing Address
First Line : 1991 FORDHAM DR STE 102
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3774
Country : US
Telephone Number : 910-484-4653
Fax Number : 910-483-9256
Provider Business Practice Location Address
First Line : 1991 FORDHAM DR STE 102
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3774
Country : US
Telephone Number : 910-484-4653
Fax Number : 910-483-9256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2025
Last Update Date : 01/07/2026

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Directions to “ RYAN DAVID PARKER ” Practice Location

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