Most Relevant Information
Provider Data
| NPI Number: | 1003330184 |
| Provider Name: | MANUEL STEPHEN RYAN |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/31/2017 |
| Last Updated: | 07/31/2017 |
Provider Practice Location
121 SAWGRASS PT
HARRISON
AR
726013072
Practice Location Phone/Fax
| Phone: | 8703913871 |
| Fax: | 8703913874 |
Provider Mailing Location
4171 N CROSSOVER RD
FAYETTEVILLE
AR
727034591
Provider Mailing Phone/Fax
| Phone: | 4795211427 |
| Fax: | 4795216520 |