Provider Demographics
NPI:1104351543
Name:MANELY, RYAN JAY (DHSC, LAT, ATC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JAY
Last Name:MANELY
Suffix:
Gender:M
Credentials:DHSC, LAT, ATC
Other - Prefix:DR
Other - First Name:PETE
Other - Middle Name:
Other - Last Name:MANELY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DHSC, LAT, ATC
Mailing Address - Street 1:321 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:KS
Mailing Address - Zip Code:67579-1927
Mailing Address - Country:US
Mailing Address - Phone:620-278-6178
Mailing Address - Fax:
Practice Address - Street 1:125 WEST COOPER
Practice Address - Street 2:STERLING COLLEGE
Practice Address - City:STERLING
Practice Address - State:KS
Practice Address - Zip Code:67579
Practice Address - Country:US
Practice Address - Phone:620-278-4393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-004572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer