Provider Demographics
NPI:1518077031
Name:PARDEN, RYAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:PARDEN
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 1:1012 FIELDSTONE CT SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-3902
Mailing Address - Country:US
Mailing Address - Phone:256-881-4827
Mailing Address - Fax:
Practice Address - Street 1:7736 HIGHWAY 20 W
Practice Address - Street 2:SUITE 3
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806
Practice Address - Country:US
Practice Address - Phone:256-430-0178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPTA3452OtherLICENSE#