Most Relevant Information
Provider Data
| NPI Number: | 1003819558 |
| Provider Name: | RYAN PATRICK WANTZ A.T.C |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | RT003251 |
Most Important Dates
| Enumeration Date: | 05/28/2005 |
| Last Updated: | 07/17/2015 |
Provider Practice Location
1 S STEWART AVE
RIDLEY PARK
PA
190781002
Practice Location Phone/Fax
| Phone: | 6105911832 |
| Fax: |
Provider Mailing Location
PO BOX 16858
PHILADELPHIA
PA
191420858
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |