Provider Demographics
NPI:1386251049
Name:KEGG, RYAN JOSEPH (PT, DPT, OSC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JOSEPH
Last Name:KEGG
Suffix:
Gender:M
Credentials:PT, DPT, OSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 DEER RUN LN
Mailing Address - Street 2:
Mailing Address - City:ALUM BANK
Mailing Address - State:PA
Mailing Address - Zip Code:15521-8352
Mailing Address - Country:US
Mailing Address - Phone:814-977-4819
Mailing Address - Fax:814-401-1167
Practice Address - Street 1:119 FOLLMAR LN
Practice Address - Street 2:
Practice Address - City:ALUM BANK
Practice Address - State:PA
Practice Address - Zip Code:15521-8201
Practice Address - Country:US
Practice Address - Phone:814-401-1167
Practice Address - Fax:814-401-1182
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0270312251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic