Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT-1246 | WY |
N | 2251G0304X | Physical Therapist - Geriatrics | PT-1246 | WY |
Y | 2251N0400X | Physical Therapist - Neurology | PT-1246 | WY |
N | 2251S0007X | Physical Therapist - Sports | PT-1246 | WY |
N | 2251X0800X | Physical Therapist - Orthopedic | PT-1246 | WY |
NPI | 1639618671 |
---|---|
Provider Name | Dr. Ryan Schrock |
First Address | Gillette, WY 82718-5582 |
Second Address | Gillette, WY 82718-5582 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2017 |
Last Update Date | 16/09/2019 |