Provider Demographics
NPI:1184215808
Name:RYAN, COLE LEON (DPT)
Entity Type:Individual
Prefix:DR
First Name:COLE
Middle Name:LEON
Last Name:RYAN
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 1:4449 PETAL DR UNIT 202
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-6356
Mailing Address - Country:US
Mailing Address - Phone:740-262-4365
Mailing Address - Fax:
Practice Address - Street 1:1725 HERITAGE TRL STE 301
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-8716
Practice Address - Country:US
Practice Address - Phone:239-649-6848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT019012225100000X
FLPT36608225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist