| NPI | 1477640894 |
|---|---|
| Former Name | MARISA LYNN RYAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 7092) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01208100) |
| 225100000X Physical Therapist (Licence: PA PT017984) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2009-06-03 |