Provider Demographics
NPI:1053629600
Name:BAIR, JOHN RYAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RYAN
Last Name:BAIR
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 1:882 S MATLACK ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-4505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:882 S MATLACK ST
Practice Address - Street 2:SUITE 104
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-4505
Practice Address - Country:US
Practice Address - Phone:610-696-5076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020920225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist