Provider Demographics
NPI:1588813042
Name:NIX, RYAN WAYNE (PT, DPT, CERT DN)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:WAYNE
Last Name:NIX
Suffix:
Gender:M
Credentials:PT, DPT, CERT DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 RIVER OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4544
Mailing Address - Country:US
Mailing Address - Phone:501-593-0954
Mailing Address - Fax:
Practice Address - Street 1:5220 W 12TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1857
Practice Address - Country:US
Practice Address - Phone:501-663-2908
Practice Address - Fax:501-663-3994
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3085225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist