MEDICARE: RYAN HAWK

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	225100000X	Physical Therapist	16622	TN

General Provider Information

NPI Number	:	1639056781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN HAWK

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-702-4389
Fax Number	:

Provider Business Practice Location Address
First Line	:	4654 NASHVILLE HWY
Second Line	:
City	:	CHAPEL HILL
State	:	TN
Zip	:	37034-2126
Country	:	US
Telephone Number	:	931-364-4666
Fax Number	:

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

Provider Enumeration Date	:	08/20/2025
Last Update Date	:	08/20/2025

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Directions to “ RYAN HAWK ” Practice Location

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