Provider Demographics
NPI:1598145567
Name:RYAN, AUSTIN (HAS,HIS)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:RYAN
Suffix:
Gender:
Credentials:HAS,HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 PLANTATION RIDGE DR STE 140
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9175
Mailing Address - Country:US
Mailing Address - Phone:704-360-4788
Mailing Address - Fax:704-251-6746
Practice Address - Street 1:8085 SPYGLASS HILL RD
Practice Address - Street 2:
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940-7984
Practice Address - Country:US
Practice Address - Phone:321-253-6310
Practice Address - Fax:704-251-6746
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237700000X
SCHAS-0553237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist