Provider Demographics
NPI:1396551297
Name:DEVLIN, RYANE MICHELE (PTA)
Entity type:Individual
Prefix:MS
First Name:RYANE
Middle Name:MICHELE
Last Name:DEVLIN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:124 FOLSOM AVE APT A
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:PA
Mailing Address - Zip Code:19033-1603
Mailing Address - Country:US
Mailing Address - Phone:484-356-7468
Mailing Address - Fax:
Practice Address - Street 1:340 N MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5597
Practice Address - Country:US
Practice Address - Phone:610-891-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI001447225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant