Provider Demographics
NPI:1124283379
Name:CARMAN, RYAN JAMES (PTA)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:JAMES
Last Name:CARMAN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 21ST ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-6106
Mailing Address - Country:US
Mailing Address - Phone:330-837-5399
Mailing Address - Fax:
Practice Address - Street 1:875 8TH ST NE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-8503
Practice Address - Country:US
Practice Address - Phone:330-832-8761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-26
Last Update Date:2008-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06555225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant