MEDICARE: WILLIAM MICHAEL RYKER M.S.

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	101YM0800X	Mental Health Counselor	L.P.C.#809	WY

General Provider Information

NPI Number	:	1467451955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM MICHAEL RYKER M.S.

Provider Business Mailing Address
First Line	:	PO BOX 1005
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82003-1005
Country	:	US
Telephone Number	:	307-634-9653
Fax Number	:	307-638-8256

Provider Business Practice Location Address
First Line	:	103 PARK AVE
Second Line	:
City	:	WHEATLAND
State	:	WY
Zip	:	82201-3319
Country	:	US
Telephone Number	:	307-322-3190
Fax Number	:	307-322-3198

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	07/08/2007

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