MEDICARE: RYAN M DAVIS DPT

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	PTL.0017641	CO
2	225100000X	Physical Therapist	5501019712	MI

General Provider Information

NPI Number	:	1902419237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN M DAVIS DPT

Provider Business Mailing Address
First Line	:	5520 FIESTA LN APT C
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-6708
Country	:	US
Telephone Number	:	719-895-1722
Fax Number	:	719-895-1723

Provider Business Practice Location Address
First Line	:	1202 E FILLMORE ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-6402
Country	:	US
Telephone Number	:	719-895-1722
Fax Number	:	719-895-1723

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

Provider Enumeration Date	:	08/26/2020
Last Update Date	:	06/04/2026

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