MEDICARE: MEGAN KRISTINE RYAN ATC

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	2255A2300X	Athletic Trainer	2000055548

General Provider Information

NPI Number	:	1447098116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN KRISTINE RYAN ATC

Provider Business Mailing Address
First Line	:	1 BOBCAT CIRCLE
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59717
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BOBCAT CIRCLE
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718
Country	:	US
Telephone Number	:	406-994-4221
Fax Number	:

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

Provider Enumeration Date	:	07/17/2024
Last Update Date	:	06/09/2026

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