Provider Demographics
NPI:1326505389
Name:O'NEIL, RYAN LEE
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:LEE
Last Name:O'NEIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 W 24TH PL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-2449
Mailing Address - Country:US
Mailing Address - Phone:913-244-6959
Mailing Address - Fax:
Practice Address - Street 1:1615 NAISMITH DR LAWRENCE KS 66045
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66045-0001
Practice Address - Country:US
Practice Address - Phone:913-244-6959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer