Most Relevant Information
Provider Data
| NPI Number: | 1003367202 |
| Provider Name: | MICHAEL RYAN PT, ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT15572 |
Most Important Dates
| Enumeration Date: | 10/23/2016 |
| Last Updated: | 10/23/2016 |
Provider Practice Location
1312 3RD ST N
JACKSONVILLE BEACH
FL
322507348
Practice Location Phone/Fax
| Phone: | 9044655277 |
| Fax: |
Provider Mailing Location
184 SUMMERFIELD DR
PONTE VEDRA BEACH
FL
320822639
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |