Provider Demographics
NPI:1396060588
Name:RYAN, CYNTHIA H (RPH)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:H
Last Name:RYAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 13TH AVE N
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-5067
Mailing Address - Country:US
Mailing Address - Phone:563-242-5944
Mailing Address - Fax:563-243-4094
Practice Address - Street 1:915 13TH AVE N
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-5067
Practice Address - Country:US
Practice Address - Phone:563-242-5944
Practice Address - Fax:563-243-4094
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18133183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist