Provider Demographics
NPI:1235912270
Name:RYKEN, SAVANNAH (DPT)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:RYKEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 E BESSEMER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-6328
Mailing Address - Country:US
Mailing Address - Phone:850-768-0177
Mailing Address - Fax:
Practice Address - Street 1:901 W 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6384
Practice Address - Country:US
Practice Address - Phone:928-726-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19930225100000X
AZCP024094T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist