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1235396045
RYAN NIEHAUS
BLOOMINGTON, IN
NPI
1235396045
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207QS0010X Family Medicine, Sports Medicine
(Licence: IN 02004042A)
Enumeration Date
2008-05-20
Last Update Date
2020-12-18
Business Address
RYAN NIEHAUS D.O.
995 S CLARIZZ BLVD
BLOOMINGTON, IN 47401-5588
Phone number: 812-353-3060
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Mailing Address
RYAN NIEHAUS D.O.
PO BOX 1329
BLOOMINGTON, IN 47402-1329
Phone number: 812-353-3087
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