Provider Demographics
NPI:1699435727
Name:PLSEK, RYAN
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:PLSEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11888 FULLER ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-1818
Mailing Address - Country:US
Mailing Address - Phone:706-831-1063
Mailing Address - Fax:
Practice Address - Street 1:11888 FULLER ST
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-1818
Practice Address - Country:US
Practice Address - Phone:706-831-1063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician