Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 6604 | OR |
NPI | 1245587971 |
---|---|
Provider Name | Scott Preston Ranek |
First Address | Tyndall, SD 57066-2116 |
Second Address | Keizer, OR 97303-4568 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2012 |
Last Update Date | 13/08/2012 |