Provider Demographics
NPI:1164820106
Name:MARQUART, RYAN MICHAEL (PT)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:MICHAEL
Last Name:MARQUART
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-3030
Mailing Address - Country:US
Mailing Address - Phone:828-550-3923
Mailing Address - Fax:828-354-0209
Practice Address - Street 1:90 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-3030
Practice Address - Country:US
Practice Address - Phone:828-550-3923
Practice Address - Fax:828-354-0209
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist