ALTA L RYAN

ROCKFORD, IL
NPI1639104359
Former NameALTA RUNKLE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LX0001X Nurse Practitioner Obstetrics & Gynecology
(Licence: IL  209.000800)
Enumeration Date2006-07-11
Last Update Date2015-07-01
Business Address
ALTA L RYAN
209 9TH ST SUITE 200
ROCKFORD, IL 61104-2235
Phone number: 779-696-2750
Mailing Address
ALTA L RYAN
PO BOX 1567
ROCKFORD, IL 61110-0067
Phone number:
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