Most Relevant Information
Provider Data
| NPI Number: | 1003814849 |
| Provider Name: | RYAN J NETTLES PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 05-25395 |
Most Important Dates
| Enumeration Date: | 07/13/2005 |
| Last Updated: | 06/06/2011 |
Provider Practice Location
3651 COLLEGE BLVD
#100A
LEAWOOD
KS
662111904
Practice Location Phone/Fax
| Phone: | 9133197546 |
| Fax: | 9133197691 |
Provider Mailing Location
3651 COLLEGE BLVD
#100A
LEAWOOD
KS
662111904
Provider Mailing Phone/Fax
| Phone: | 9133197546 |
| Fax: | 9133197691 |