Provider Demographics
NPI:1073106142
Name:MUELLER, RYAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:MUELLER
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 1:114 SUNBIRD CLIFFS LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-8013
Mailing Address - Country:US
Mailing Address - Phone:847-502-5971
Mailing Address - Fax:719-691-7994
Practice Address - Street 1:114 SUNBIRD CLIFFS LN
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-8013
Practice Address - Country:US
Practice Address - Phone:847-502-5971
Practice Address - Fax:719-691-7994
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00147992251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology