Provider Demographics
NPI:1982013819
Name:POWELL, RYAN JEFFREY (DPT)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JEFFREY
Last Name:POWELL
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12130 OLD MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8787
Mailing Address - Country:US
Mailing Address - Phone:317-569-0100
Mailing Address - Fax:
Practice Address - Street 1:12130 OLD MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-8787
Practice Address - Country:US
Practice Address - Phone:317-569-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT29496225100000X
IN05015330A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist