Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT018101 | OH |
NPI | 1043798119 |
---|---|
Provider Name | Ryan J Teknipp |
First Address | Columbus, OH 43240-6110 |
Second Address | Columbus, OH 43240-6110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2018 |
Last Update Date | 04/11/2019 |