Provider Demographics
NPI:1346691532
Name:LAUGHLIN, RYAN M (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:M
Last Name:LAUGHLIN
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-1201
Mailing Address - Country:US
Mailing Address - Phone:518-590-6855
Mailing Address - Fax:
Practice Address - Street 1:250 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-1201
Practice Address - Country:US
Practice Address - Phone:518-590-6855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003151-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer