Most Relevant Information
Provider Data
| NPI Number: | 1003247891 |
| Provider Name: | RYAN SANDERS GARY PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 5501016584 |
Most Important Dates
| Enumeration Date: | 12/05/2013 |
| Last Updated: | 11/07/2014 |
Provider Practice Location
1331 LAKE DR SE
SUITE 105
GRAND RAPIDS
MI
495061674
Practice Location Phone/Fax
| Phone: | 6162489842 |
| Fax: | 6162489848 |
Provider Mailing Location
1331 LAKE DR SE
SUITE 105
GRAND RAPIDS
MI
495061674
Provider Mailing Phone/Fax
| Phone: | 6162489842 |
| Fax: | 6162489848 |