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ISHMAEL RYAN ATC

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1740756030

Individual Registrant:
 ISHMAEL  RYAN ATC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1201 N SCENIC HWY  BABSON PARK, FL 33827-9751 US
Tel: 904-477-2059  Fax: --

Contact information for business:
1320 EAGLES CLAW CT  JACKSONVILLE, FL 32225-0816 US
Tel: 904-477-2059  Fax: --

Registration Information:
NPI: 1740756030
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
FLAL5097

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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