Provider Demographics
NPI:1316221211
Name:HOUGH, RYAN DAVID (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:DAVID
Last Name:HOUGH
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18039 JOSEPHINE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136-1307
Mailing Address - Country:US
Mailing Address - Phone:402-960-3252
Mailing Address - Fax:402-934-0973
Practice Address - Street 1:18039 JOSEPHINE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-1307
Practice Address - Country:US
Practice Address - Phone:402-960-3252
Practice Address - Fax:402-934-0973
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8127225100000X
NV1790225100000X
CA28787225100000X
MO2010011117225100000X
KS11-04079225100000X
KY5591225100000X
NE2853225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist