Provider Demographics
NPI:1992499925
Name:MATHERNE, RYDER CHRISTIAN (DPT)
Entity type:Individual
Prefix:
First Name:RYDER
Middle Name:CHRISTIAN
Last Name:MATHERNE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4044 15TH ST
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-4004
Mailing Address - Country:US
Mailing Address - Phone:504-237-1385
Mailing Address - Fax:
Practice Address - Street 1:3820 LAPALCO BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2317
Practice Address - Country:US
Practice Address - Phone:504-708-5618
Practice Address - Fax:504-708-5608
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist