Provider Demographics
NPI:1518013630
Name:GARMAN, RYAN M (MPT)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:M
Last Name:GARMAN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4204 MENOMONEE RIVER PKWY
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1135
Mailing Address - Country:US
Mailing Address - Phone:262-893-1102
Mailing Address - Fax:
Practice Address - Street 1:756 N 35TH ST
Practice Address - Street 2:STE 203
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-3360
Practice Address - Country:US
Practice Address - Phone:414-763-1237
Practice Address - Fax:414-763-2923
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10271-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist