Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 9698 | TN |
NPI | 1003245739 |
---|---|
Provider Name | Ryan Schaefer |
First Address | Franklin, TN 37068-1478 |
Second Address | Nashville, TN 37215-2809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2013 |
Last Update Date | 09/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0446631 | (05) | TN |