Provider Demographics
NPI:1972068658
Name:ANTHONY, RYAN K
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:K
Last Name:ANTHONY
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 1:7165 TALASI DR
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-3830
Mailing Address - Country:US
Mailing Address - Phone:405-250-4991
Mailing Address - Fax:
Practice Address - Street 1:10940 S PARKER RD # 503
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7440
Practice Address - Country:US
Practice Address - Phone:303-922-4636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist