Provider Demographics
NPI:1235433525
Name:RYDER, HARLA M (LMT)
Entity Type:Individual
Prefix:MS
First Name:HARLA
Middle Name:M
Last Name:RYDER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 E NIELSON AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-1346
Mailing Address - Country:US
Mailing Address - Phone:480-234-8982
Mailing Address - Fax:
Practice Address - Street 1:1945 E NIELSON AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-1346
Practice Address - Country:US
Practice Address - Phone:480-234-8982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-01
Last Update Date:2011-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-112432081H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative Medicine